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| Sus-Prhine was once a top-line treatment for asthma in emergency rooms. |
This is one of the few times where the medical profession dispelled a myth and realized the truth before me. Various studies in the late 1980's and early 1990's showed that albuterol was equally effective as epinephrine at opening airways. It was also shown to be far safer.
The most convincing study was published in 1991, and I wrote about it in my post, "1991: Study finds albuterol works just as well as albuterol."
The study gave albuterol and epinephrine to various children of an average age around 8-years-old, and the various testing done showed that both medicines were equally effective at ending asthma attacks.
So, it is basically for this reason why doctors give albuterol to asthmatics rather than epinephrine. Epinephrine is sometimes offered as a last resort prior to intubating asthmatics, but it's either never given because albuterol eventually works (or, more likely, the systemic corticosteroids start working), or it is given and fails to work. It fails to work because albuterol was already probably given ad nauseum, and epinephrine is not better than albuterol.
Even recently I have wondered why we don't just give epinephrine to some asthmatic patients who come in with asthma exacerbations. Here we have access to this shot that could just open them up in a matter of minutes, as opposed to giving albuterl ad nauseum.
The reason I am such a victim of this myth is because epinephrine benefited me so many times when I was a kid. I'd go to the doctor's office or emergency room and the shot would start opening my airways within five minutes. It created a feeling of euphoria. I mean, if you can't breathe and all of a sudden you can, you'd feel euphoria too. Although, some of this effect was probably the product of the medicine.
The last time I was given it was in 1991. When I asked for Sus-phrine, which was basically a long-acting form of epinephrine, the doctor had no idea what I was talking about. At this point, it had been six years since I had needed it or asked for it.
However, the pharmacist found a vial, and I was given it. And it opened my airways up. A few months later I went to the emergency room again. This time the doctor convinced me to try this new medicine called albuterol. I had actually had an albuterol inhaler, but never tried the solution before.
To my surprise, it worked just as well as the epinephrine at opening my airways up. I remember being excited about this new medicine. When I asked about it the therapist said it was a safer version of Alupent (the solution I had at home at the time).
A week later I had my own prescription for albuterol. I have been using it ever since. Still, it never dawned on me that this new albuterol thing was equally as effective as epinephrine for another 16 years. I mean, it's kind of a "Duh!" But, you know, it was hard for me to give up on the idea that a medicine that saved my life so many times could be replaced.
If you want to learn more about epinephrine, Sus-phrine, or gain access to the study referenced here, check out the following links.
Further reading:
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