Sidney Friedlaender

A controlled study of cromolyn sodium sponsored by the Drug Committee of the American Academy of Allergy

Abstract Because of several controversial reports concerning the efficacy of cromolyn sodium in the treatment of asthma, the Drug Committee of the American Academy of Allergy instituted a collaborative study in November, 1969. The protocol was designed to select patients according to age, cooperativeness, severity of asthma, and type of asthma—extrinsic, intrinsic, or mixed. The basic design of the study involved a baseline period of one week in which inert filler (lactose) was administered in the Spinhaler apparatus and during which the patient could be familiarized with the complex record keeping. The basal period was followed by two 4 week crossover periods during which cromolyn sodium was alternated with placebo. Symptom scores, drug intake, physician evaluation, patient preference, and simple pulmonary function tests were subjected to statistical analysis. Results gleaned from 252 completed patients indicated a favorable response for the drug as compared to placebo in patient symptom scoring, ephedrine-like drug scores, physician evaluation, and patient preference. A drug carry-over effect extending over a period of 4 weeks created difficulty in assessing results of the placebo period in patients who received active drug during the first 4 week period. Although a favorable drug effect was usually observed when cromolyn sodium was the first drug in the trial sequence, efficacy was more clear-cut during active drug administration in patients who received placebo during the first 4 weeks of the study. The mechanism of this carry-over effect was not apparent. The amelioration index tended to be higher in the pediatric group and in those patients whose asthma was classified as mixed. No change in the objective indices of one-second forced expiratory volume or peak expiratory flow measured once every 2 weeks was obtained. No serious side effects were noted by the participating investigators. These results indicate that cromolyn sodium will be a useful adjunct to the pharmacological treatment of asthma.

Aspirin allergy; its relationship to chronic intractable asthma.

Excerpt For some time we have recognized a rather characteristic type of asthmatic patient whose symptoms are of unusual severity and chronicity, and who in addition presents a history of hypersens...

Relief of dermographism and other urticarias of histamine origin by a synthetic benzhydryl alkamine ether

Abstract The new histamine antagonist, β-dimethylaminoethyl benzhydryl ether hydrochloride, is an effective palliative remedy in dermographism and is particularly useful in the type of dermographism interfering with cutaneous testing for atopic manifestations.

Histamine Antagonists. V. Comparison of Benadryl and Pyribenzamine in Histamine and Anaphylactic Shock

Summary The LDloo of histamine was first determined in a control group of guinea pigs. It was found that approximately 5 times this amount was required to kill all animals previously treated with 3 mg/kg of Benadryl, while 35 times the lethal dose of histamine was necessary to produce 100% mortality in animals receiving 3 mg/kg of Pyribenzamine. No apparent difference was discernible between the 2 drugs in preventing anaphylaxis in passively sensitized guinea pigs. One mg/kg of either compound gave significant protection against a shocking dose of antigen, while 3.0 mg/kg prevented fatal anaphylaxis in all animals tested.

Penicillinase in the treatment of allergic reactions to penicillin

Abstract A purified form of penicillinase was used in treatment of fifty cases of sensitivity reactions related to the administration of penicillin. Rapid improvement following intramuscular administration was observed in some cases of reactions of the serum sickness type, acute urticarial and nonurticarial cruptions, and chronic urticaria. A number of similar cases failed to improve with the same treatment. Two injections of 800,000 units each at three-day intervals appeared more effective than a single dose. Its mode of action is such that it does not appear to have a place in the treatment of immediate anaphylactic reaction. Local pain and swelling and systemic febrile reactions were commonly encountered after intramuscular injections of the enzyme. Intravenous use is not advised. The antigenicity of penicillinase is such that the possibility of sensitization from repeated administration must be considered in its use.

Vitamin C in hay fever: Therapy and blood levels

Abstract 1.1. Hay fever patients have a normal blood level of vitamin C. 2.2. Large doses (500 mg. daily) of vitamin C produce the usual saturation blood levels, but do not change the course of the hay fever or asthma.

Experimental and clinical evaluation of synthetic anti-histaminic drugs.

Abstract β-dimethylaminoethyl benzhydryl ether hydrochloride (benadryl) and pyridil-N′-benzyl-N-dimethylethylenediamine (pyribenzamine) are two new synthetic substances possessing marked anti-histaminic and anti-anaphylactic properties. They are being used in many allergic disorders with varying degrees of success. Side effects are frequent and varied, limiting the dosage employed. Both drugs appear most successful in controlling the lesions of urticarial dermatoses, and are of value in other conditions in which an anti-pruritic effect is desirable. Their action in allergic rhinitis and seasonal hay fever is less definite. Beneficial results in asthma are questionable. Where successful, the action of both compounds is of a palliative and not of a curative nature. Their effect is of relatively brief duration, and symptoms almost invariably recur a short time after withdrawal. The importance of determining allergic factors responsible in each case is not diminished by their use.

Spectral absorption characteristics of antihistaminic drugs; relationship to ultraviolet erythema.

Abstract 1.1. The ultraviolet absorption spectra were determined for the following antihistaminic drugs: Benadryl, Pyribenzamine, Neo-Antergan, Neohetramine, Decapryn, Pyrrolazote, Antistine, Trimeton, Thenylene, Tagathen, Thephorin, AH-853 (Parke, Davis), and C-5581H (Bristol). These data obtained with the Beckman Quartz Spectrophotometer show that Pyribenzamine, Thenylene, Neo-Antergan, Pyrrolazote, Tagathen, Neohetramine, and Antistine possess absorption bands within the active portion of the ultraviolet spectrum (2950 to 3150 A.). The remaining compounds tested do not significantly absorb the erythema-producing rays. 2.2. Clinical studies in normal skin with ointment preparations of these drugs parallel the spectrophotometric findings. Those which possess an absorption band in the 2950 to 3150 A. region prevent erythema ordinarily produced by exposure to the radiations of the quartz mercury arc lamp. This action is demonstrable when the ointments are applied either directly to the skin or when placed on a square of quartz overlying the skin. The drugs without absorption characteristics in this zone of the spectrum do not appreciably affect the erythema response. This would indicate that the inhibitory action shown by some of these drugs is related to their spectral absorption characteristics. 3.3. The oral ingestion of antihistaminic drugs before exposure to the mercury are radiations and at regular intervals for a period of twenty-four hours afterwards failed to affect the development of the erythema reaction. This did not differ when either an absorbing or nonabsorbing drug was used. 4.4. Introduction of antihistaminic drugs beneath the superficial layers of the skin failed to affect the development of ultraviolet erythema. This is in marked contrast to the inhibition displayed when similar concentrations of the absorbing drug are applied to the skins surface. 5.5. Surface application of absorbing and nonabsorbing drugs to normal skin already exposed to ultraviolet radiations failed to impair the development of the erythema response. 6.6. Preliminary clinical studies indicate that antihistaminic drugs which absorb the active part of the ultraviolet spectrum may be employed effectively as sunburn preventives. 7.7. The results of these studies fail to support the concept that histamine release in the tissues is the principal factor involved in the production of ultraviolet erythema.

The use of inhaled medications in school by students with asthma

Students with asthma frequently have the sudden onset of asthma symptoms from a variety of causes, including exercise. In most cases, asthma can be prevented or treated by inhaled medications. For many students with asthma to function normally at school, these prescribed medications must be readily accessible to the individual. Students whose parents and physician judge that they have sufficient maturity to control the use of these inhaled medications should be allowed to retain these inhalers in their possession. School policies that require inhalers to be kept in school official’s or nurse’s offices result in an interference in the medical needs of the patient and may seriously delay treatment. Most students will not properly use their medications under these circumstances, School officials should discuss with parents or physicians of students with asthma any problems regarding appropriateness and responsibility of use of these medications. Otherwise, schools should cooperate in the best interest of the patient by permitting the student to have possession of their inhaled medication. There is no indication that these medications have any potential for abuse by students without asthma. Therefore, it should not be argued that this policy presents any danger to other students. It is reasonable to expect that the student requiring inhaled medication to be sufficiently responsible and discreet in its use to avoid drawing attention to treatment. Therefore, we recommend that students with asthma be permitted to have in their possession inhaled medications for the treatment and the prevention of asthma symptoms when they are prescribed by that student’s physician.

Report of the committee on drugs of the research council of the American academy of allergy, 1958–1959

The activities of the Committee on Drugs during the past year have included the clinical evaluation of prednisone (Meticorten) and prednisolone (Meticortelone), phenyltoloxamine-resin complex (Histionex), bronchodilator JB-251, zinc-ACTH, and gamma globulin. In addition, the Committee has furnished advisory services to the Food and Drug Administration, physicians, pharmaceutical manufacturers, and the public regarding drugs used in the treatment of allergy, as well as assistance in the investigation of unsubstantiated claims for drug treatment of allergic states.