Chronic, persistent asthma should be treated according to the National Asthma Education and Prevention Program guidelines. 2 In athletes with confirmed EIB, a reasonable approach is to start with a short-acting beta 2 agonist before exercise ( Figure 1 ) . If regular dosing of a short-acting beta 2 agonist is needed, or if EIB is not controlled with short-acting beta 2 agonists, a second-line agent (., leukotriene receptor antagonist, mast cell stabilizer, inhaled corticosteroid with or without a long-acting beta 2 agonist) can be added. Inhaled corticosteroids and leukotriene receptor antagonists are the preferred agents in persons with underlying asthma. Leukotriene receptor antagonists are preferred in persons with allergic rhinitis. When prescribing medications to high-level athletes (., those who participate in the National Collegiate Athletic Association or the Olympics), physicians should be aware of which medicines require a waiver ( Table 4 32 , 33 ) . Patients should be reassessed periodically; if a satisfactory response is not achieved, the diagnosis of EIB should be reconsidered. Enlarge Print
Suggested doses :
Large joints: 2 to 4 mg
Small joints: to 1 mg
Bursae: 2 to 4 mg
Tendon Sheaths: to 1 mg
Injections may be repeated from once every 3 to 5 days to once every 2 to 3 weeks
-Dose will vary according to the degree of inflammation and the size and location of the affected site.
-Intrasynovial and soft tissue injections should be limited to 1 or 2 sites; frequent intra-articular injections may cause damage to joint tissue.
Use: As adjunctive therapy for an acute episode or exacerbation of synovitis of osteoarthritis, rheumatoid arthritis, acute and subacute bursitis, acute gouty arthritis, epicondylitis, acute nonspecific tenosynovitis, and posttraumatic osteoarthritis.