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Ephedrine and pseudo-ephedrine in asthma, bronchial asthma and enuresis
308 the Luithlen-Urbach out. A considerable subject is appended.
THE
JOURNAL
OF
ALLERGY
method. Other causes for symptoms were ruled bibliography dealing with various phases of the
“badon,” a New Ephedrine Derivative, Asthma. Handorsky, H. : Miinchen.
in the Treatment med. Wchnschr.
of Bronchial 81: 326, 1934.
‘ ‘Isalon, ” an ephedrine derivative. was tested both clinically and in animals for its effect on the bronchi and was found to be strongly antibronchospastic. This was tested by perfusing lungs under experimental conditions with Tyrodes’ solution containing dilutions of pilocarpin. After the injection of Isalon much greater concentrations of pilocarpin were required to cause bronchial constriction than at the beginning of the experiment. At the same time, it has but little or practically no eff’ect on the blood pressure. Dogs narcotized with chloralose, showed after Isalon a fall in blood pressure, whereas the same dose of ephedrine under similar conditions showed a rise in pressure. In man, therapeutic doses have little effect. Gram for gram, it, is only half as toxic as ephedrine. IJnlike adrenalin, it is not, quickly destroyed. Its only efY& is on the sympathetic endings.
‘ ‘ Lsalcm, ’ ’ a Synthetic Deriva,tive of Ephedrine, ;ts a Specific Asthma Remedy. Kubeja, E.: Miinchen. med. Wchnschr. 81: 327, 1934. Clinical observations on asthmatic patients treated wit,11 ‘(Isalon” show that it has a very favorable effect in controlling paroxysms. A particular virtue is that its action is essentially on t’he bronchi, and it has practically no effect on the vasculature. The various side etYects induced by adrenalin and ephedrine, such as headache, restlessness, elevation of blood pressure, etc.? are scarcely experienced by the use of Isalon. Morerer, the drug has a more prolonged effect.
Ephedrine and Pseudo-Ephedrine in Asthma, Bronchial Asthma a,nd Enuresis. Christopherson, J. B., and Broadbent, M. : Brit. RI. J. 1: 978, 1934. The studies undertaken were part of an inquiry arranged by the Therapeutic Trials Committee of the Medical Research Council into the relative values of ephedrine and pseudo-ephedrine. The two alkaloids occur together in varying proportions in several species of Ephedra.. They have the same chemical structure but differ physically. Patients with asthma were divided into (a) spasmodic cases, that is, those without evidence of bronchitis, and (b) bronchial cases with gross evidence of bronchitis. In spasmodic asthma 24 patients were treated successively with the two alkaloids, there being an interval between the courses of the two drugs during which the patients were treated with inert tablets. The drugs were given ordinarily at bed-
ABSTRACTS
309
time in doses of l/4 to 2 grains, according to the age of the patient. Five patients had no bad attacks during the period of observation ; 15 patients were relieved of wheezing by both alkaloids, but pseudoephedrine was less effective. The results in 37 cases of so-called bronchial asthma were as follows: 20 patients had no severe att,acks, and in 15 of these pseudoephedrine taken regularly relieved the mild constant wheezing. In 9 it was effective in relieving slight attacks. In the 8 cases in which acute attacks occurred, it was not effective. In comparing further the action of the two alkaloids, it was concluded that pseudo-ephedrine is valuable as a mild bronchial sympathetic stimulant, sufficiently active to give relief in the chronic wheezing and dyspnea of asthma. It is a useful prophylactic against nocturnal dyspnea of asthma, and against the dyspnea of exertion in chronic It does not effectively take the place of ephedrine, still bronchitis. It is noncumulative in its action, less of adrenalin, in acute attacks. and produces fewer side effects than ephedrine in the same dosage. Generally speaking, although not always, about double the dosage of pseudo-ephedrine is required to produce the equivalent physiologic effect of a given dose of ephedrine.
THE
JOURNAL
OF
ALLERGY
method. Other causes for symptoms were ruled bibliography dealing with various phases of the
“badon,” a New Ephedrine Derivative, Asthma. Handorsky, H. : Miinchen.
in the Treatment med. Wchnschr.
of Bronchial 81: 326, 1934.
‘ ‘Isalon, ” an ephedrine derivative. was tested both clinically and in animals for its effect on the bronchi and was found to be strongly antibronchospastic. This was tested by perfusing lungs under experimental conditions with Tyrodes’ solution containing dilutions of pilocarpin. After the injection of Isalon much greater concentrations of pilocarpin were required to cause bronchial constriction than at the beginning of the experiment. At the same time, it has but little or practically no eff’ect on the blood pressure. Dogs narcotized with chloralose, showed after Isalon a fall in blood pressure, whereas the same dose of ephedrine under similar conditions showed a rise in pressure. In man, therapeutic doses have little effect. Gram for gram, it, is only half as toxic as ephedrine. IJnlike adrenalin, it is not, quickly destroyed. Its only efY& is on the sympathetic endings.
‘ ‘ Lsalcm, ’ ’ a Synthetic Deriva,tive of Ephedrine, ;ts a Specific Asthma Remedy. Kubeja, E.: Miinchen. med. Wchnschr. 81: 327, 1934. Clinical observations on asthmatic patients treated wit,11 ‘(Isalon” show that it has a very favorable effect in controlling paroxysms. A particular virtue is that its action is essentially on t’he bronchi, and it has practically no effect on the vasculature. The various side etYects induced by adrenalin and ephedrine, such as headache, restlessness, elevation of blood pressure, etc.? are scarcely experienced by the use of Isalon. Morerer, the drug has a more prolonged effect.
Ephedrine and Pseudo-Ephedrine in Asthma, Bronchial Asthma a,nd Enuresis. Christopherson, J. B., and Broadbent, M. : Brit. RI. J. 1: 978, 1934. The studies undertaken were part of an inquiry arranged by the Therapeutic Trials Committee of the Medical Research Council into the relative values of ephedrine and pseudo-ephedrine. The two alkaloids occur together in varying proportions in several species of Ephedra.. They have the same chemical structure but differ physically. Patients with asthma were divided into (a) spasmodic cases, that is, those without evidence of bronchitis, and (b) bronchial cases with gross evidence of bronchitis. In spasmodic asthma 24 patients were treated successively with the two alkaloids, there being an interval between the courses of the two drugs during which the patients were treated with inert tablets. The drugs were given ordinarily at bed-
ABSTRACTS
309
time in doses of l/4 to 2 grains, according to the age of the patient. Five patients had no bad attacks during the period of observation ; 15 patients were relieved of wheezing by both alkaloids, but pseudoephedrine was less effective. The results in 37 cases of so-called bronchial asthma were as follows: 20 patients had no severe att,acks, and in 15 of these pseudoephedrine taken regularly relieved the mild constant wheezing. In 9 it was effective in relieving slight attacks. In the 8 cases in which acute attacks occurred, it was not effective. In comparing further the action of the two alkaloids, it was concluded that pseudo-ephedrine is valuable as a mild bronchial sympathetic stimulant, sufficiently active to give relief in the chronic wheezing and dyspnea of asthma. It is a useful prophylactic against nocturnal dyspnea of asthma, and against the dyspnea of exertion in chronic It does not effectively take the place of ephedrine, still bronchitis. It is noncumulative in its action, less of adrenalin, in acute attacks. and produces fewer side effects than ephedrine in the same dosage. Generally speaking, although not always, about double the dosage of pseudo-ephedrine is required to produce the equivalent physiologic effect of a given dose of ephedrine.