There have been treatments for asthma for at least a thousand years. The ancients used jimson weed to relax the muscles surrounding the large airways in the lungs (these are known as anticholinergic agents for you drug nerds out there).
When epinepherine (epi) was first discovered in 1903, it provided instant relief by relaxing the bronchial tubes in the lungs that tense up during an asthma attack. (The Chinese used the herb Ma-huang, the plant species Ephedra sinica, because it mimicked epinephrine.)
Even though there were ways to treat asthma way back then, I couldn't imagine being an asthmatic in those days. In 2004, thr FDA banned products containing ephedra because the risk of injury, illness and death. Jimson weed can be toxic. The problem with epi is that it was a nonselective drug -- it didn't just dilate the bronchioles, it also affected the heart, a bad deal for the elderly and those with bad hearts.
In the 1970s and 1980s when I was growing up with severe, persistent asthma, a new selective medicine called Alupent was available. It was inhaled directly into the lungs and worked quicker and had fewer systemic side effects. Still, epi was more powerful a bronchodilator, so doctors used it in the ER for severe asthma.
Then there was a longer-acting version of epi called Susphrine (or Sus-phrine)that was popular among the medical community in the region where I grew up. I was two when I got my first Susphrine shot in 1972. When my family went on vacation across the country to California in 1976, my doctor wrote a note for mom to carry with her just in case my asthma struck:
"This boy is a known asthmatic undergoing hyposensitization program. If he
has severe asthma attack without fever he will respond well to 0.2cc Susphrine
sub q stat; observe 20 minutes. Thank You, Dr. Gunderson."
The years 1980 to 1985 were the asthma years I remember the most. Mom or dad took me to the ER for asthma many times and each time I got a Susphrine shot. One October in 1984, I sat in the ER cot lumbering for air.
An RT in a white lab coat came into my room to give me Alupent. I wanted Susphrine. My chest burned. It felt like a herd of elephants was sitting on me.
About five minutes later, a nurse came in the room to finally give me the shot I needed. It was 3:45. I kept my eye on the clock, watching the red second hand mosey its way round and round. I looked at dad. His hair was disheveled. He had wrinkles from sleep on the left side of his face, and circles under his eyes. Perhaps he was wishing he could trade places with me. I wouldn't wish this on him, though, because he'd probably panic -- I was experienced and knew how to handle this kind of distress.
I peered back at the clock concentrating on each breath. It was 3:47. I thought I could take in a deeper breath, but it was just my imagination. Then, 3:48, I took in a deep breath. Finally. Relief.
A feeling of euphoria rushed through me. I'm telling you folks, there is no better feeling than going from near suffocation to taking a full, deep breath in less than ten minutes. If you go through that even once, you will never take breathing for granted again.
Thirty minutes later I felt like bouncing around the room. The adrenaline was taking its systemic effect. Despite that, I felt like a million bucks.
Susphrine is no longer used in ERs anymore. In fact, it's not even produced anymore, nor is it listed in the Physician's Desk Reference (PDR). Epi is still used on occasion, but it is basically reserved as a last ditch option for stubborn asthma.
Recently, I stopped our big pharmacist as he lumbered down the hall. I said, "Hey, Mike, do you remember an old medicine called Susphrine. When I was a kid, that stuff saved my life more than once."
"Oh, yeah," he said after he racked his brain, "I remember it. We used to use it quite a bit in fact until about 10 to 15 years ago when they took it off the market. Asthmatics loved it." He was the only person I quizzed who remembered the drug.
It's amazing that asthma medicines have improved so much even since I was a kid. Most asthmatics who use their preventative medications compliantly don't even need to make visits to the ER anymore. But, those who do will NOT get a shot of the asthma wonder drug of old, but they'll get new asthma wonder drugs that are proven faster and safer.
Published On: January 12, 2009