In the last section of the packet is a list of all the medicines used to treat asthma at that time. Most of these medicines I was on, and if you had asthma in the 1980s, chances are you were on one or more of these too.
So, without further adieu, here is the list of the top line asthma medicines for 1981. Or rather, here is the medicine and the facts about them as per 1981 wisdom. I'm going to reproduce it here as it was actually written in lecture format:
I. Facts about medicine for the child with asthma
A. No curative medicine
B. Control asthma when taken as prescribed
C. Medicine must be evaluated for effectiveness
D. Take only the medicine prescribed for you
1. Most effective and used medicine
2. Action on the bronchial muscles and known as a "bronchodilator"
3. Prescribed under many brand names:
- Theospan and many others
- Gastro-intestinal system
- Central nervous system
B. Beta2 Adrenergics and related medicines
1. Medicines similar to epinephrine and are bronchodilators
- Metaproterenol (Alupent and Metraprel)
- Terbutaline (Bricanyl and Brethine)
- Isoetharine (Bronkosol)
- Isopreterenol (Isuprel)
- Epinephrine (Adrenalin)
- Gastro-intestinal system
- Central Nervous system
1. Acts by lessening response of lungs to triggers
2. Needs to be taken regularly
3. No effect after wheezing starts
4. Inhaled as a dry powder and may stimulate coughing
1. Related to cortisone, a hormone naturally secreted by the adrenal glands
2. Inhibit inflammatory reaction
3. Most effective medicine for a flare-up of asthma symptoms
4. Side effects
- Change in body shape: (1) Increase appetite, (2) Weight gain, (3) Round-faced look
- Change in growth: (1) Growth interfered with during long term use, (2) Severe asthma my interfere with growth
- Adrenal suppression: (1) Adrenal glands become "lazy", (2) Gradual reduction of steroids to stimulate production of glands again
a. Prednisone (Deltasone, Paracort, Meticorten)
b. Prednisolone (Sterane, Delta-Cortef)
c. Methylprednisolone (Medrol)
d. Beclomethasone (Vanceril, Beclovent)
- Inhaled into lungs
- Avoid side effects of steroids taken by mouth
- Disadvantages: (a) Difficult for small children to use, (b) Not effective for acute attacks of asthma, (3) May irritate the throat, (4) May allow thrush to develop in mouth
1. Decongestants and Antihistamines
a. Given for relief of congestion and/ or allergic rhinitis
b. Many brand names
- Antihistamines: (a) Chlortrimeton, (b) Teldrin, (c) Atarax, (d) Benadryl
- Decongestants: (a) Sudafed
- Combination (Antihistamines and Decongestants): (a) Drixoral, (b) Actifed, (c) Dimetapp
A. Take as prescribed by physician
B. Learn all about the medicine
C. Devise a system of taking medicine to help with compliance
- Self-care model
So you can see there have been a lot of changes as far as medicine is concerned when it comes to treating asthma since the 1980s. I was actually surprised to see Theophylline as the #1 asthma medicine, but I shouldn't have been. It was a top line medicine from the 1950s until about 2000.
This era was right at the peak of trying to prevent asthma attacks as opposed to just treating acute asthma symptoms. Yet it was known back then that airway swelling (inflammation) was involved in the acute asthma attack, it was not known asthma was a disease of chronic (always there) inflammation.
Theophylline is now rarely used, and Intal is off the market. Epinepherine is rarely used, replaced by Ventolin (continuous if necessary) in emergency rooms. All the other beta adrenergics listed above are no longer available due to side effects.
I was surprised to see that Ventolin, Azmacort and Atrovent weren't on the above list, as they were all on the market. One reason may be (I'm guessing here) was that they were all under patent and more expensive than other options on this list. Of course this list was made in 1981 and I was a patient in 1985, and was prescribed a ventolin inhaler and azmacort.
Some pretty good opitons were available back then. We asthmatics were pretty fortunate compared to... well, we were just fortunate.