Tedral

[3][4][5] However, at high dose, it may lead to cardiac arrhythmias, hypertension, seizures or other serious cardiovascular and/or central nervous system adverse effects.

Being used as a treatment option for respiratory diseases for decades, Tedral was withdrawn from the US market in 2006 due to safety concerns.

[3] These include the inhibition of nuclear factor-kappaB prevents the translocation of the pro-inflammatory transcription factor (NF-kappaB) to the nucleus, thereby reducing the expression of known inflammatory genes in conditions such as COPD and asthma.

When ephedrine is used in long-term, the catecholamine excess can bring about contraction band necrosis of the myocardium, which predisposes the heart to ventricular arrhythmias.

[5] Concerning the adverse effects of phenobarbital after long-term usage, loss of appetite, depression, irritability, achiness in the bones, joints, or muscles, and liver damage may occur.

[9] Ephedrine's alpha-adrenergic stimulation causes contraction of the smooth muscle at the base of the bladder, resulting in resistance to urine output.

[9] In addition, due to excessive norepinephrine availability at the synapse, which could induce a hypertensive crisis via the indirect sympathomimetic effect of ephedrine, Tedral should be avoided or used with caution within 14 days of monoamine oxidase inhibitor (MAOI) therapy.

[25] In the 1920s and 1930s, ephedrine was introduced as a treatment for asthma and other respiratory conditions due to its bronchodilating effect and ability to increase blood flow to the lungs.

[26] The combination of theophylline and ephedrine was first used in the 1940s as a treatment for asthma, and the addition of a barbiturate such as pentobarbital or phenobarbital was later added to enhance the sedative effects of the medication and improve patient compliance.

[28] It was widely used throughout the 1960s and 1970s, but its popularity declined in the 1980s due to the development of newer, more effective medications for asthma and COPD, such as inhaled corticosteroids, long-acting beta-agonists, leukotriene modifiers and immunomodulators.

The US Food and Drug Administration (FDA) had previously issued warnings about the use of ephedrine-containing products due to their potential for serious side effects, including heart attack, stroke, and death.

In the case of Tedral, its manufacturer, Novartis Pharmaceuticals Corporation, voluntarily withdrew the medication from the market in 2006 after the FDA issued a warning letter to the company citing safety concerns related to the use of ephedrine.

Asthma is a chronic condition that affects the airways in the lungs. The image shows the difference between a healthy bronchial airway (left) and a bronchial airway during an asthma attack (right). Exposure to asthma triggers can lead to inflammation and narrowing of airways in asthma patients, resulting in asthma attacks and breathing difficulties. [ 12 ] And Tedral exerts its therapeutic effects by decreasing airway responsiveness to allergens and relaxing the smooth muscle of the airways, thereby, making breathing easier.
The image above shows the difference between a normal, healthy lung (left) and a COPD patient's lung (right). Chronic obstructive pulmonary disease (COPD), is a progressive lung disease. The term COPD includes two main conditions: (1) emphysema and (2) chronic bronchitis . Emphysema develops when the walls of alveoli are destroyed, forming fewer larger alveoli. Chronic bronchitis is triggered by repeated or constant irritation and inflammation in the lining of airways. Bronchioles thus, lose their shape and become clogged with mucus . [ 17 ] These conditions result in difficulty in breathing. Symptoms can be improved by Tedral because of its bronchodilating property.
Theophylline
Ephedrine
Phenobarbital