Early Inhalation Therapy Medications

DPIs, pMDIs, and inhalation solutions commonly used during the first four decades of the respiratory therapy profession are featured in this gallery and listed by release date.

Inhaled meds from the 1940s are featured.

Normal saline, half-strength saline, and sterile distilled water were prescribed as diluents for medications delivered by IPPB and small volume nebulizers.

Dr. Alvan Barach first reported on the administration of penicillin by inhalation in the early 1940s.

Penicillin G was the first agent administered as an inhaled dry powder. By the late 1940s, Abbott produced the Aerohaler which was designed to deliver penicillin G.

Vaponefrin was registered as a trademark in 1935.

Vaponefrin (racemic epinephrine) was nebulized and commonly administered in the treatment of upper airway edema and post-extrubation stridor.

The formulation of the drug that would be released as "Isuprel" was patented in 1943.

Isuprel (isoproterenol HCl) , was one of the first bronchodilators administered via IPPB.

Isuprel was trademarked in 1947.

This ad for Asthmanefrin appeared in newspapers in the 1940s.

This kit contained a solution of Adrenalin (1:100), a bulb glass nebulizer, a dropper, and instruction pamphlet.

Respiratory medications from the 1950s are featured.

This journal ad for the Vaponefrin (Racemic epinephrine) solution indicated that it was the "textbook therapy for emphysema, asthma, and chronic bronchitis."

Alevaire, a solution of Superinone (tylaxopol), sodium bicarbonate, and glycerin, was a popular mucolytic in the 1950s-1970s.

Alevaire, described as a mucolytic in this 1955 ad, was designed for both intermittent use via IPPB and continuous nebulization in tents.

The article "Alevaire as a Mucolytic Agent" by M.L. Tainter et al appeared in the November 3, 1955 issue of the New England Journal of Medicine.

In this 1956 ad, aerosolized Alevaire was recommended for the treatment of neonatal atelectasis. Among other disorders, the ad claimed that Alevaire was effective in the treatment of bronchial asthma, pertussis, pneumonia, pulmonary complications of polio, croup, emphysema, kerosene poisoning, bronchiectasis, and lung abcess.

This ad for Alevaire is from the December 1959 issue of the INHALATION THERAPY journal .

In the early 1950s, diluted alcohol-water mixtures were nebulized and administered to patients with acute pulmonary edema. This practice continued into the 1970s.

Norisodrine (isoproterenol sulfate) was administered as a dry powder utilizing the Aerohaler as the delivery device. This ad appeared in the September 1958 issue of the INHALATION THERAPY journal.

This 1957 ad from Riker promoted their first pMDIs which contained either isoproterenol or epinephrine.

The Isuprel Mistometer contained 15 mL of an isoproterenol hydrochloride solution in a pressurized canister.

An Isuprel Mistometer is shown.

The box for the Isuprel Mistometer is shown.

Inhalation solutions and pMDIs from the 1960s are featured.

This ad, from the the October 1960 issue of the INHALATION THERAPY journal, features Tergemist.
Tergemist was described as a mucolytic aerosol solution containing "a detergent, potassium iodide, and distilled water."

Racemic epinephrine (2.25%), which was trademarked in 1962, is shown.

Micronefrin (racemic epinephrine 2.25%) was trademarked in 1961 by the Bird Corporation.

Micronefrin (2.25% solution of racemic epinephrine). It also contained 1/2 of 1% chlorobutanol, a chloroform derivative, as a preservative agent.

The box for the 7.5 mL bottle of Micronefrin, a racemic epinephrine solution, from Bird Corporation is shown.

Micronefrin (racemic epinephrine) was trademarked in 1961 by the Bird Corporation. The drug insert pamphlet is shown.

Dornovac (pancreatic dornase) was featured in this ad in the April 1963 issue of the INHALATION THERAPY journal.

Dornovac (pancreatic dornase) is featured in this 1965 ad from the October 1965 issue of the INHALATION THERAPY journal.

Mucomyst (acetylcysteine) was introduced in 1963 and was offered in 10% and 20% solutions.

Vapo-N-Iso was a 0.5% solution of isoproterenol distributed by the U.S. Vitamin and Pharmaceutical Corporation of New York.

Vapo-N-Iso contained a 0.5% solution of isoproterenol HCl.

It was trademarked in 1963.

This ad for Isuprel appeared in a late 1960s issue of the INHALATION THERAPY journal.

Bronkometer's original formula of isoetharine, phenylephrine, and thenyldiamine is described in this ad.

The Bronkometer box states that it contains 10 mL of Dilabron (isoetharine ) mesylate 0.61% (w/w), phenylephrine HCl 0.125% (w/w) with saccharin, menthol, alcohol 30% (w/w) and with fluorochlorohydrocarbons as gaseous propellants. preserved with ascorbic acid 0.1% (w/w). The revised formula "does not contain the antihistaminic Thenyldiamince HCl."

Bronkometer 10 mL isoetharine mysylate and phenylephrine. This revised formula did not contain the antihistaminic Thenyldiamine HCl.

This ad for Bronkosol appeared in the April 1968 issue of INHALATION THERAPY.

Bronkosol (isoetharine and phenylephrine) was trademarked in 1966.

The side label of a Bronkosol bottle is shown.

The side label of a Bronkosol bottle is shown.

Breon's revised formula of Bronkosol primarily contained Dilabron (Isoetharine HCl 1.0% and Phenylephrine HCl 0.25% in an aqueous glycerin solution with saccharin sodium with sodium chloride, sodium bisulfite, methylparaben, and propylparaben as preservatives.

The reverse side of the box for Bronkosol indicated the average dose for an all glass or plastic hand nebulizer was 4 inhalations. It was also for use by "oxygen aerosolization or in IPPB machines."

Inhalation solutions and MDIs from the 1970s are featured.

The AsthmaNefrin automatic aerosol canister indicates it contained 15 c.c. of racemic epinephrine.

The box for AsthmaNefrin Aerosol Mist indicated that the refill contained 300 measured doses or 15 c.c. of racepinephrine.

Bricanyl (terbutaline sulfate) was approved by the FDA in 1974.

Breon's second revised formula for the Bronkometer, circa 1972, contained Isoetharine mesylate 0.61% (W/W) contained saccharine, menthol, alcohol 30% (W/W), and with fluorochlorohydrocarbons as gaseous propelllants. Preserved with ascorbic acid 0.1% (W/W)

Bronkometer (20 mL) bottle of Isoetharine mesylate

Intal (cromolyn sodium) was introduced in the early 1970s

. A capsule containing a dry powder of the agent, was inserted into the delivery device called the Spinhaler. The capsule was pierced and the powder was released and delivered to the patient on inspiration.

An Intal Spinhaler and Intal capsules are shown.

The Spinhaler is shown disassembled with the Intal capsule in place.

A whistle attachment could be added to the Spinhaler and would sound when correct breathing techniques was used.

Inhalation solutions and MDIs from the 1980s are featured.

Brethaire (terbutaline sulfate) was supplied as an MDI. It was approved by the FDA in 1984.

The Brethancer was designed for use with the Brethaire MDI.

In 1984, the Brethancer spacer by Geigy was marketed for use with the Brethaire (terbutaline) MDI.

Allen and Hanbury's Ventolin (Albuterol sulfate) inhalation solution (0.5%)

Ventolin was approved by the FDA in 1987.

A Ventolin Rotahaler is shown in its carrying case.

A Ventolin Rotahaler and Ventolin Rotacaps capsules are shown.

The unit dose kit consisted of a Rotahaler and 24 Ventolin (albuterol sulfate) Rotacaps capsules.

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