Asthma Medicines

The use of epinephrine by injection for the treatment of asthma dates to as early as 1903. An aerosol form was developed around 1910. For many decades epinephrine was the only available medication for the treatment of bronchial asthma. Its use in the emergency setting has certainly saved countless numbers of lives.

In view of the fact that epinephrine is a nonselective agent that has potent effects on the heart and circulation, its use for treating bronchial asthma has declined. In elderly patients in particular, administration of epinephrine may result in increases in blood pressure and heart rate. These effects may contribute to the development of stroke and heart attack. For these reasons, emergency room treatment of bronchial asthma usually consists of the administration of a selective B-adrenergic agonist by nebulization.

For Anaphylaxis

Epinephrine is still an important medication for treating severe allergic reactions. It is the treatment of choice for a severe reaction known as anaphylaxis, a total body allergic reaction that may lead to collapse or shock. One example is the severe reaction to a bee sting in a sensitive individual. Injectable preparations of epinephrine that automatically inject a premeasured dose are available by prescription for highly allergic patients.

Over-the-Counter Medication

Over-the-counter nonprescription preparations of aerosol epinephrine should be avoided. These preparations are extremely weak and short acting with effects that may last only a few minutes, and therefore are commonly abused. With the far more effective treatment available for bronchial asthma I feel these agents would best be withdrawn since they may actually deter patients from seeking appropriate and necessary medical attention.

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