Isoetharine methanesulfonate with phenylephrine hydrochloride and thenyldiamine (Bronkometer) in hypertensive and sympathomimetic amine-sensitive asthmatic patients.

H E SEARCH FOR AN EFFECTIVE AEROT s o l that would not rake the blood p m u r e of patients with bronchospasm has been going on ever since the introduction of nebulized epinephrine in 1935.' The substitution of isoproterenol in 1947' led to decreased side effects, but there was still a 4 per cent incidence of palpitations, newousnes and/or headaches.' Isoetharine by aerosol relieved bronchmpasm and caused no significant side effects in 102 patients.' In 1958, an antihistamine (thenyldiamine) and a bronchovasoconstrictor (phenylephrine) were added to the isoetharine,' thus forming the mixture used in the pressurized-aerosol form. This combination has proved safe and effective in relieving bronc h c s p a . in f o u r separate studies,in each of which a few hypertensive patients were treated without difficulty. Because hypertensive asthmatic patients have been difficult to manage, we felt that further investigation of the effect of this combination of drugs on these patients was warranted. We also used it on three patients with hypersensitivities to sympathomimetics, as a sort of acid test of the degree of stimulating side effects.