Exercise Intolerance

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Exercise Intolerance

• PHM 226
• Amina Ali (amina.ali_at_utoronto.ca)
• Sonya Edelshteyn (s.edelshteyn_at_utoronto.ca)
• Daphne Geslani (daphne.geslani_at_utoronto.ca)
• Marsha Jejna (marsha.jejna_at_utoronto.ca)

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What is Exercise Intolerance?

• A symptom
• Inability to do physical exercise at expected
  level
• During exercise unusual breathlessness, fatigue,
  muscle pain or weakness
• After exercise severe pain, headache,
  nausea, extreme fatigue
• Possible Causes heart conditions,
  back pain, mitochondrial myopathy,
  exercise-induced anaphylaxis

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What is Exercise-Induced Anaphylaxis


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r.com/50226711/images/anaphylaxis.jpg

• A physical allergy that encompasses a broad range
  of symptoms
• Urticaria affects 10 to 20 of the population
• Can be aggravated by food and medication

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Pathophysiology

• Increased IgE
• Mast cell degranulation
• Histamine release causing vasodilation of small
  blood vessels
• Increased levels of leukotrienes

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/Vasodilation.jpg
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Relevant Vasoactive Mediators Released by Mast
Cells and Basophils in Anaphylaxis
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ent/allergy/anaphylaxis/table2.htm
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nagement_hypersens.gif
Immunological Mechanism of Anaphylaxis
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Biochemical Pathway
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/part1/prostag.htmgt
8
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Clinical Significance for Pharmacists

• Signs and symptoms
• Differential diagnosis
• Pharmacotherapy
• Non-pharmacological management

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Summary

• Condition characterized by inability to do
  physical exercise at expected level
• Hives linked to physical activity, shortness of
  breath, edema
• Preventative Anti-histamines, leukotriene
  antagonists, lipoxygenase inhibitors
• Treatment Epi-pen

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References

• Hosey, R (2001 October 15). Exercise-Induced
  Anaphylaxis and Urticaria. American Academy of
  Family Physicians, Retrieved March 5, 2007, from
  http//www.aafp.org/afp/20011015/1367.html
• Exercise intolerance . Retrieved March 11, 2007,
  from Answers.com Web site http//www.answers.com/
  topic/exercise-intolerance
• Colucci, W.S (2005 May 26). Skeletal muscle
  dysfunction and exercise intolerance in heart
  failure. Up to Date Patient Information,
  Retrieved March 11, 2007, from http//patients.upt
  odate.com/topic.asp?filehrt_fail/17135