1900-1960: Key developments in asthma

The most productive years in the history of asthma medicine came between 1900 and 1960.  Key developments in this era changed the way asthmatics live, and for the better

The developments were as follows:

1900:  Epinephrine was discovered.  I wrote about this here.

1903:  Epinephrine was injected into the arm of an athmatic and, within minutes, an asthma attack was ended.  This was the first recorded use of asthma rescue medicine.

1910:  The first aerosolized epinephrine treatment was given.  The nebulizer used was primitive -- by modern standards anyway -- but relief was felt almost immediately.  This was the first recorded breathing treatment with a nebulzer.

1930s:  The first mass producible electric nebulizer hits the market.  Asthmatics now had access to fast acting rescue medicine in the comfort of their own home, and whenever they needed it.  For the first time the asthmatic didn't have to hunt down a doctor with each asthma attack when relief was sought.  I wrote about the history of nebulizers here.

1936: Iseotharene was synthesized in 1936 as the first successful modification of epinephrine. (1)

1940s: Iseotharine was marketed as Aleudrin in Germany

1948:  The terms beta-2 Adrenercic is first described by Raymond Ahlquis.   Beta 2 adrenergic receptors (B2) were discovered to line smooth muscles that wrap around air passages in the lungs.  When stimulated, these receptors cause these muscles to relax and the airways to dilate.  It's B2 stimulation by rescue medicine that ends an asthma attack.  Since this discovery rescue medicine is sometimes referred to as beta-2 agonists, or simply beta agonists. (3)

1948:  The terms beta 1 Adrenergic (B1) and alpha-1 adrenergics (A1) are described also described by Raymond Ahlquis.  A1 and B1 receptors line heart muscle, and when stimulated the heart rate increases in rate and force.  Epinephrine was found to be attracted to B1, B2 and A1 receptors.  So this explained why the instant breathing relief came with side effects.

1948:   Isopretoronol was learned to have a stronger B2 effect than epinephrine, yet it also had a strong B1 effect that caused the heart to speed up "even when administered via inhalation."  So Isopretoronol still had to be used with discretion. (4)

1951: Iseotharine was approved by the FDA and marketed as Bronkosol.   It became yet another option via the nebulizer route, although, like epinepherine, it only lasted one and a half to two hours. It was the first B2 specific rescue medicine to hit the market.   It had a stronger beta effect and less of an alpha effect.  It was marketed as the first B-2 specific inhaled aerosolized bronchodilator.  Bronkosol had less of a beta 2 effect than Isopretoronol, yet it was more desirable because of the decreased cardiac affect.  The medicine still only lasted one and a half to two hours.  (5)

1957:  The first metered dose inhaler hits the market.  Riker Pharmaceuticals introduced the Medihaler-Epi and the Medihaler-Iso which had epinephrine and isoprotoronol respectively.  For the first time ever asthmatics had a handy little inhaler to carry with them wherever they went.  The medicine provided instant relief from an asthma attack without the hassle of hunting down a doctor, or dealing with fragile and complicated nebulizers, solutions and hand held squeeze bulbs.  I wrote about this in more detail here.

Click here for more asthma history.

References:

1. Brenner, Barry E, ed., "Emergency Medicine," 1998, from chapter one "Where have we been?  A history of acute asthma," page 23
2. Rau, Joseph L., "Inhaled Adrenergic Bronchodilators: Historical Development and Clinical Application," at AARC.org (American Association of Respiratory Care, July, 2000, Vol. 45, number 7),
3. Rau, ibid
4. Rau, ibid
5. Rau, ibid