Medieval peasants, poisonous rye fungus, racing hearts, and one of the most important inhalers ever invented. In this episode, Dr. Adam J. Brown continues the asthma series with the strange history of beta-2 agonists and albuterol. We begin with ephedra, ephedrine, and early plant-based asthma treatments, then follow the trail through ergot-contaminated rye, Henry Dale’s experiments with ergotamine and adrenaline, and the discovery that the sympathetic nervous system was working through more than one receptor. From there, we trace Raymond Ahlquist’s alpha/beta receptor breakthrough, the rise of epinephrine and isoproterenol as asthma therapies, the asthma death epidemic of the 1960s, and the leap that separated beta-1 from beta-2 receptors. That discovery opened the door to albuterol—an inhaler designed to target the lungs more than the heart, and still one of the most important rescue treatments in asthma.

• (00:00:00) - Introduction
• (00:00:58) - Ephedrine: The Mongolian Asthma Remedy
• (00:02:26) - Ergot: Medieval Pregnant Cows
• (00:04:50) - Henry Dale and the Ergot Mystery
• (00:06:43) - Adrenaline and the Sympathetic System
• (00:08:24) - The Ergotamine-Adrenaline Paradox
• (00:11:10) - Ahlquist Discovers Alpha and Beta Receptors
• (00:12:34) - Early Modern Asthma Treatments
• (00:13:36) - Isoproterenol and the Asthma Death Epidemic
• (00:15:16) - Beta-1 vs Beta-2 Receptors
• (00:15:17) - Albuterol: Modern Rescue Inhaler