Best treatment for exercise induced asthma is

The stepwise approach to the management of asthma Step 1: Occasional use of inhaled sho-acting b2-adrenoreceptor agonist bronchodilators A variety of different inhaled devices are available and the choice of device should be guided by patient preference and competence its use. The metered-dose inhaler remains the most widely prescribed . For patients with mild intermittent asthma (symptoms less than once a week for 3 months and fewer than two nocturnal episodes per month), it is usually sufficient to prescribe an inhaled sho-acting b2-agonist, such as salbutamol or terbutaline, to be used as required. However, many patients (and their physicians) under-estimate the severity of asthma. A history of a severe exacerbation should lead to a step-up in treatment. (BUD), fluticasone, mometasone or ciclesonide) should be staed in addition to inhaled b2-agonists taken on an as-required basis for any patient who: * has experienced an exacerbation of asthma in the last 2 years * uses inhaled b2-agonists three times a week or more * repos symptoms three times a week or more * is awakened by asthma one night per week. For adults, a reasonable staing dose is 400 ug beclometasone dipropionate (BDP) or equivalent per day in adults, although higher doses may be required in smokers. Alternative but much less effective preventive agents include chromones, leukotriene receptor antagonists and theophyllines. The preferred asthma medications are sho-acting beta-2 agonists such asalbuterol. Taken 10 minutes before exercise, thesemedicationscan prevent the airways from contracting and help control exercise-induced asthma. Having good control of asthma in general will also help prevent exercise-induced symptoms Ref Davidson edition23rd pg 571