Sodium cromoglicate

Intravenous delivery to lungs of antiallergic compounds Sodium cromoglicate (Cromolyn sodium)... 

Rynacrom containing sodium cromoglicate is available as a nasal spray used in allergic rhinitis. 

In allergic rhinitis the first choice treatment is a non sedating antihistamine, per oral or nasal. Local treatment with sodium cromoglicate often works well, sometimes in combination with antihistamines. In severe nasal congestion a local steroid is usually needed to alleviate the symptoms. 

Causes are largely unclear complaints of food intolerances are often made, but clear evidence of specific and consistent adverse effects is hard to obtain (a distinction is drawn here from genuine dietary allergy which responds to avoidance of the offending item, for instance shellfish, and use of oral sodium cromoglicate). The basis of irritable bowel syndrome rests somewhere in the hinterland of perception of dysfunction, and otherwise normal but exaggerated physiological colonic responses. 

Bone mineral density was measured after 7.4 months in 49 asthmatic children, 38 of whom took inhaled beclomethasone, average daily dose 276 micrograms, and 11 sodium cromoglicate, average daily dose 30 mg (121). Children who had used beclomethasone had grown as much as those who used sodium cromoglicate. Trabecular and cortical bone mineral density in the proximal forearm and lumbar spine increased to the same extent in both groups. 

Antihistamines and intranasal corticosteroids are the first-line treatments for allergic rhinitis. Sodium cromoglicate, ipratropium bromide and decongestants, are alternative or add-on treatments. Drug treatment should be selected according to the severity, frequency and duration of symptoms ... 

Mild persistent or moderate-severe intermittent use an oral or intranasal antihistamine, or an intranasal corticosteroid (e.g. beclometasone or fluticasone). Intranasal decongestants and sodium cromoglicate are useful add-on drugs. 

Moderate-severe persistent intranasal corticosteroids are the drug of choice. Antihistamines, intranasal decongestants, and sodium cromoglicate are alternatives if steroids are contraindicated, or can be used as add-on drugs. Ipratropium bromide is useful for people with persistent watery effusion. 

Topical mast cell stabilisers are best used for prophylaxis of allergic eye symptoms. Sodium cromoglicate is effective in most people. Lodoxamide and nedocromil are more expensive, but may be worth trying in people with inadequate response to sodium cromoglicate. Mr JA cannot use eye drops because he wears contact lenses therefore nasal corticosteroids are recommended. 

There is some evidence that children under five years of age obtain benefit from use of nedocromil sodium or sodium cromoglicate. These agents are used only in prophylaxis cromoglicate is not a bronchodilator and cannot be used to treat acute episodes of asthma. Its action is not well understood but the prophylactic effect appears to be partly due to stabilization of mast cells, which reduces release of histamine and other mediators so that hyperactive bronchial muscle is less responsive to environmental triggers. 

Children may benefit from asthma prophylaxis using sodium cromoglicate or nedocromil sodium. 

Sodium cromoglicate is used for prophylaxis in asthma when there appears to be an allergic basis to the condition. Although its mechanism of action is not well understood, it appears to reduce the release of inflammatory agents from mast cells and so is useful in asthma prophylaxis, particularly in children. It is unlikely to be of value in COPD. 

As a powder, e.g. sodium cromoglicate. Particle size and air flow velocity are important. Most particles above 5 micrometres in diameter impact in the upper respiratory areas particles of about 2 micrometres reach the terminal bronchioles a large proportion of particles less than micrometer will be exhaled. Air flow velocity diminishes considerably as the bronchi progressively divide, promoting drug deposition peripherally. 

By preventing the release of histamine from storage cells glucocorticoids and sodium cromoglicate can suppress IgE-induced release from mast cells. Pj-agonists have a similar effect. 

Some patients develop wheeze that regularly follows within a few minutes of exercise. A similar response occurs following the inhalation of cold air since the common mechanism appears to be airway drying. Inhalation of a p -adrenoceptor agonist, sodium cromoglicate (see below) or one of the newer leukotriene receptor antagonists (see below) prior to either challenge prevents broncho-constriction. 

Sodium cromoglicate is effective in extrinsic (allergic) asthma including asthma in children, and in exercise-induced asthma but its use has declined since the efficacy and safety of low dose inhaled corticosteroid have become apparent. 

Anti-inflammatory agents can commence either with sodium cromoglicate or low-dose inhaled gluco-... 

Most antiasthma treatment is therefore aimed either at reducing release of inflammatory cytokines (glucocorticoids and sodium cromoglicate) or at direct bronchodilatation by stimulation of the bronchial [)j-adrenoceptors. 

Repirinast is an antiallergic prodrug whose active metabolite has a stabilizing action on mast cells that resembles that of sodium cromoglicate (1). 

Relative to the gastrointestinal mucosa the pulmonary epithelium possesses a high permeability to water soluble molecules, which is an advantage with dmgs such as sodium cromoglicate (IX), a bischromone with two carboxylic acid groups and a pK of approximately 1.9. The dmg is well absorbed from the... 

Structure IX Sodium cromoglicate (DSCG sodium cromo-glycate cromolyn sodium)... 

Dmgs administered by inhalation are mostly intended to have a direct effect on the lungs. However, the efficiency of inhalation therapy is often not high because of the difficulty in targeting particles to the sites of maximal absorption. Only about 8% of the inhaled dose of sodium cromoglicate administered from a Spinhaler device (see section 9.9.2) reaches the alveoli. ... 

When used by patients, the Spinhaler delivers about 25% by weight of sodium cro-moglicate, which is normally dispersed as particles below 6 m in diameter, about 5% being less than 2 m diameter. The mass medium diameter (and geometric standard deviation) of the sodium cromoglicate particle batches used were, respectively, 2 f.2 and f f.7 f.f m. There is no doubt that the biological effect of the small particle material is... 

Figure 9.50 Correlation between Hie percentage dose absorbed after nasal administration and molecular weight 4oxo-4H-l-benzopyran-2 arboxylic acid (chromocarb) ( ) paminohippuric acid (A) sodium cromoglicate (O) inulin ( ) dextran ( ) r = -0.996.

Figure 10.6 Phase diagram for mixtures of disodium cromoglicate (DSCG, sodium cromoglicate) and tetradecyldimethy-lammonium bromide (C,4BDAC).

Sodium cromoglicate Mast cell stabilizer 80 mg Once daily Jet nebulizer Maintenance therapy, prophylaxis for heaves... 

Sodium cromoglicate Mast cell stabilizer 200 mg b.i.d. Jet nebulizer Inflammatory ain/vay disease (mast cells > 2%)... 

Mast cell stabilizers are indicated for the treatment of inflammatory airway disease in some horses. Inflammatory airway disease is observed in yoimg horses the clinical syndrome is characterized by poor exercise performance, chronic cough and the presence of exudate in the tracheobronchial tree. A subset of horses with inflammatory airway disease will have metachromatic inflammation in bronchoalveolar lavage, with mast cells constituting 2-5% of the total cell count. This form of chronic lower airway inflammation probably represents a local pulmonary hypersensitivity reaction. There is controversy as to whether this form of inflammatory airway disease represents an early form of recurrent airway obstruction. Nebulization of sodium cromoglicate (200 mg) will improve the clinical signs of respiratory disease and will stabilize mast cell histamine release (Hare et al 1994). 

Sodium cromoglicate Clarityn Allergy Eye Drops Hay-Crom Eye Drops Opticrom Allergy Eye Drops (5 mL and 10 mL) Optrex Allergy Eye Drops Vividrin Eye Drops Allergic conjunctivitis... 

Sodium cromoglicate Hay-Crom, Opticrom, Vividrin Allergic conjunctivitis and seasonal... 

Sodium cromoglicate eye drops should help to relieve the symptoms and perhaps a systemic non-drowsy antihistamine such as loratadine would also help, but the real problem is the source of the allergen (i.e. the kitten) and if the problem continues serious consideration should be given to re-homing the animal. 

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