This medication can be administered as an aerosol powder, a metered aerosol or a respirator solution. Commonly known as Intal, this sodium cromoglycate is designed for long-term prophylactic use. After using Intal, physiological improvement has been noted in both allergic and non-allergic asthmatics. Intal can be effective in preventing exercise-induced asthma if it is used a few minutes before starting to exercise.
Studies are underway to determine exactly how Intal prevents mast cells from releasing the mediators that cause allergic and non-allergic inflammatory reactions. What is known so far is that Intal seems to reduce non-specific bronchial hyper-reactivity.
Whenever you find that you are starting to experience asthma symptoms, it is recommended that you use Intal a few minutes after a bronchodilator spray has opened up the airways, thus allowing Intal to penetrate deeply into the lungs. If you are using the Intal respirator solution, it can be mixed for the same effect with a beta-agonist solution in a nebulizer. As with all the medications discussed in this book, the recommended doses of Intal should be worked out with your doctor.
SIDE EFFECTS OF INTAL
Intal has very mild side effects, such as coughing or a slight irritation after breathing in the powder. Most people report no side effects at all.
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Although manipulative methods are mainly applicable only by another person, there is one limited — but usually effective — technique which the patient may apply to himself. In cases of distressing spasm in the heart region, relief from the pain can often be achieved by the following: With the fingers and thumb of the right hand  slightly fanned—each separated from its neighbours by about a finger’s width — rest the tip of the thumb in the notch at the top of the breastbone. The tips of the index and middle fingers will now be found to lie in two shallow, adjacent grooves between the ribs. Pushing the tips of these fingers into the flesh, keep the pressure on firmly for as long as seems necessary to ease the distress. Usually about a minute is enough. Please be quite clear: this is not a curative treatment; it is merely a harmless method of gaining relief.
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What you are actually feeling when you take your pulse is the waves of blood travelling from the heart along a main artery. The pulse is normally felt at the wrist, because the beat is strong and in an easily accessible place, but pulses can be felt in many other parts of the body, such as the neck.
To take your pulse, use a watch that shows seconds. Hold the watch in your left hand and hold the left wrist with your right hand – move the first two fingers of your right hand until you can feel the pulse just under your thumb on the left wrist. Count the number of beats that occur during a thirty second interval and then multiply by two to get the number of beats per minute. To get the ‘resting pulse’ you should do this first thing in the morning, while you are sitting in a relaxed position.
The next step is to work out what your safe maximum pulse rate during exercise should be. This depends on two things: your age and your current level of fitness. For a fit person, the heart can beat at a maximum of about 200 beats per minute at age 20, but at only about 150 beats at age 70. When you are exerting yourself, your pulse rate should not rise about 75 percent of your maximum. A useful and very safe formula for calculating the ideal rate for you is: 200 minus your age minus another 40 if you are very unfit. Thus for an unfit 50-year-old the rate would be: 200-50-40 = 110 beats/minute.
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