Saturday, February 25, 2017

1978: Tedral and Brondecon

During the late 1970s, there was a medicine mom gave to me when I was having trouble breathing. I remember standing just inside the bathroom door watching mom opening the medicine cabinet above the sink, grabbing the bottle, pouring some of it on a teaspoon, and feeding it to me. I remember it tasted nasty.

I do not remember if it worked. I do not remember any side effects. However, it must have worked, because I do remember asking for it. I do remember my mom observing that I was sniffling, sneezing, and wheezing, and taking me to the bathroom to take my medicine. I do remember going on vacation and forgetting to take my medicine, and then having to deal with an asthma attack with nothing to take for it other than a cough drop.

I had been thinking of this medicine for a couple years. I asked my mom about it, and she has no memory of doing this, let alone what medicine it might have been. Ironically, a few days ago I was talking to one of my fellow-asthmatic co-workers about asthma medicines we took as a kid, and she said that she took a medicine called Tedral. She said it was nasty tasting, but it worked.

The next morning I woke up around 4 a.m. and an epiphany occurred to me that I should go into the basement and look at my asthma books mom put together for me. I just re-organized them about a year ago. The books mom put together were made of acid, and many of the papers and pictures she saved were no longer bound to the pages. So I bought an acid-free picture book and remedied the situation, saving what my mom worked so hard to put together for the future version of me (the me of today -- the nerdy amateur historian).

I opened up a green storage bin and was thrilled to find the picture book right on the top. I set it on the table, sat down, and began to flip through the pages. Only a few pages in I found what I was looking for: a note from my mom dated July 14, 1978.  As a bonus, a picture of me at that age was next to the date (you can see the note and a picture of me at age 8 below)

I had looked at it many times before, but never thought to actually read it until just now. My mom was a note taker. After my doctor's appointments, I would wait in the hallway while mom talked to my doctor in his office without me. Mom would take notes. Considering I was the sickly one in the family, this was probably necessary.

You can see the note below. Item #5: "I teaspoon Tedral or Brondecon 2 p.m., 6 p.m. and 10 p.m.to August 28th."

There are a four reasons why Dr. Gunderson ordered for me to stop taking it in August. First, Tedral was recommended for asthma and seasonal allergies. So, it must have been estimated that the pollen season (hay fever) was the cause of my asthma.

Second, asthma at this time was treated as bronchospasm, and the treatment was bronchodilators. The most common one to start with was theophylline. The products Dr. Gunderson was most comfortable prescribing to kids were Tedral and Brondecon. A medical journal from 1976 described asthma as follows:
"Asthma, as a pathologic process, involves change in the terminal bronchiole. Components of the disease include mucous plugging, mucosal edema, and bronchospasm... Bronchospasm is reflected by varying degrees of respiratory difficulty and wheezing. It is important to realize that significant bronchospasm must be present before respiratory difficulty or wheezing becomes clinically apparent." (1)
Third, asthma at this time was treated as an acute disease, meaning that it was only treated when symptoms were observed. Once symptoms went away, or when asthma went back into remission, treatment was stopped.

Fourth, asthma was considered an allergic disease. Note the following description from the same article referenced above:
IgE antibody develops in response to exposure to specific antigens in susceptible individuals... . Once the antibody forms, it circulates in the serum and ultimately finds its way to the surface of mast cells throughout the body. When the patient is subsequently exposed to the antigen, it combines with this IgE antibody. The reaction results in the release of allergic chemical mediators. These substances are released in various locations throughout the body causing vascular permeability, vasodilation and bronchospasm. When these reactions occur in the lungs in significant quantity, asthma results."
The authors of the article recommended starting with one bronchodilator, and usually with a theophylline product. There were various theophylline products on the market, with Tedral being one of the most popular. It was a combination drug that was available over the counter. It included theophylline, ephedrine, and phenobarbital.

Both theophylline and ephedrine were bronchodilators. While they worked to open airways, they also cause side effects, such excitement, hyperactivity, and insomnia. Phenobarbital was a sedative, added to the product in an effort to reverse some of the side effects of the other medicines.

As I searched the Internet, I found quite a few discussions about Tedral, including one at medchats.com.

As I noted earlier,  I was too young at this time to remember any adverse effects. However, I do remember being hyperactive, excitable and having trouble sleeping. I also remember having some horrible dreams. Whether these were a side effect to medicines I would have no idea, but one can't help but to assume that this is a strong possibility.

I thought it would be neat here to publish some of the comments noted by various people about taking Tedral. Here are some of the ones I found the most interesting.

  1. When I was a kid I had asthma, and I had some yellow medicine that had a vaguely medicinal flavor, with a nasty alcohol kick, and the texture of snot, no kidding. I used to try to hide the wheezing to put off the moment when I'd have to take some Tedral. from 2001, 35 YO
  2. It tasted like black licorice and was black and gross. It was a yellow elixir. Side effect is increased adrenaline. May cause excitability and trouble sleeping. Tremors are another side effect. Heart racing and nausea signs of side effects. I remember days when I would have horrible headaches and nausea, and I now wonder if I had overdosed on this medicine. possible. I gagged because of the horrible taste. "I felt like I had so much energy I couldn't sit still. Some people note hallucinations and confusion. Thick yellow asthma me
  3. "I always wondered what happened to the spiders running around the ceiling when I was a child drinking thick yellow asthma m medicine. I thought it was only me and they were real. Used to use Teddy bears to protect me. Used from 4 years old until Primetine Mist came out
  4. I had asthma as a child for several years...was allergic to a bunch of things...pollen, dust, citrus, horse hair etc...This would have been maybe from about 1959 to 1966. I had extreme agitation and felt so hyped up. I hated the feeling. Sometimes wasn't sure which was worse...the gasping and wheezing from the asthma or the "speed" like feeling from the Tedral...(Milky looking liquid...syrupy...tasted like licorice).
  5. I took it in tablet form as a kid in the 50s and 60s. My mother, who also took 
  6. it, described the taste of the tablet (if she didn't swallow it fast enough) as
    a dirty streak across her tongue. I agreed then and can still remember it.
    Yuck! And if it didn't work, there was always a doctor's visit (ah, those were
    the days!) or a trip to ER.
These descriptions seem to fit my memories. Add in the note my mom put in my picture book, and my memory of taking a medicine that tasted horrible, and I bet Tedral was the medicine I remember. This might also explain why I abhor the taste of licorice.

Here are some descriptions from random people about taking Brondecon. 
  1.  I remember "cherry flavoured Brondecon - a bronchitis medicine I used to have as a kid. My gawd..........it was one of those medicines that you used to still be able to taste hours afterward. I think it MAKES you get better by means of scaring you into 4 hourly rituals of tasting this horrid glomp."
  2. When I was a lid my dad swore by Brondecon as a sure-fire remedy for a cough. We had a huge bottle of "Wild Cherry' flavoured hell on top of the fridge.
So, it was one of these medicines I took as a kid. As I noted earlier, I remember going on a vacation and forgetting my medicine. Considering how terrible it must have tasted, perhaps I forgot it on purpose.

As a side note here, I remember grimacing each time I was spoon fed this medicine. I remember one time mom was excited to tell me she got a different medicine. In retrospect, I bet it was Brondecon. It had a powerful taste. I remember grimacing and telling mom it was also terrible, like when we got a fluoride treatment at the dentist.

I also remember mom getting annoyed with me for saying this, and saying something like, "Well, these are the only options if you want to breathe."

"But it's nasty," I wined.

"Then I'll just get the other stuff, because it's cheaper!" she chimed.

This got me to thinking. I decided the new stuff, while nasty in and of itself, was better than the older stuff. So I decided to tolerate it. This strategy worked fine until, one day, she spoon-fed me the horrible stuff again. Needless to say, I was disappointed. I don't remember why she switched back, but at the time I figured it was because I complained. In reality, however, and knowing my mom's frugal (if not parsimonious) tendencies, I bet Tedral cost less.

Both Tedral and Brondecon were marketed by Warner-Chilcott. Both these medicines were available over the counter. Both were discontinued in 2010.

On the note you will also see # 6, which states, "Salt water nose drops 4 times daily to August 28." I hated doing that too. Can you imagine putting salt water up your nose? Yeah! Imagine being 8 YO and doing this, and not even feeling any different when you were done torturing yourself.

You can see advertising for both Tedral and Brondecon in this 1968 edition of "Diseases of the Chest." There is also an article called "Asthmatic Bronchitis" which lists various other theophylline products, including Marax, of which, I am told, tasted pretty good. 

When I showed this picture to my 8 YO daughter Laney, she said, "You look kind of nerdy in that picture." 
References:
  1. LeNoir, Michael A., Lawrence D. Robinson, outpatient management of an asthmatic child, Journal of the National Medical Association, January, 1976, page 46-50, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2609533/pdf/jnma00473-0072.pdf, accessed 2/22/17
  2. Official Publication of the College of Chest Physicians, Diseases of the Chest, vol. 53, No. 1., see advertisements for Brondecon and Tedral. 

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