Cromoglicate 1309012 224230476 2008-07-07T22:19:16Z 72.231.188.163 /* Mechanism of action */ {{drugbox | IUPAC_name = 5-(3-(6-carboxy-8-oxo-5,8-dihydronaphthalen-1-yloxy)<br>-2-hydroxypropoxy)-4-oxo-4H-chromene-2-carboxylic acid | image = Cromoglicate.png | CAS_number = 16110-51-3 | ATC_prefix = R03 | ATC_suffix = BC01 | ATC_supplemental = {{ATC|R01|AC01}} {{ATC|A07|EB01}} | PubChem = 27686 | DrugBank = APRD00336 | C=23 | H=16 | O=11 | molecular_weight = 468.367 g/mol | bioavailability = 1% | protein_bound = | metabolism = | elimination_half-life = 1.3 hours | excretion = | pregnancy_AU = <!-- A / B1 / B2 / B3 / C / D / X --> | pregnancy_US = <!-- A / B / C / D / X --> | pregnancy_category = | legal_AU = <!-- Unscheduled / S2 / S4 / S8 --> | legal_CA = | legal_UK = <!-- see expanded description below --> | legal_US = <!-- OTC / Rx-only --> | legal_status = inhaler POM, eye OTC<small>([[United Kingdom|UK]])</small> | routes_of_administration = topical: oral, nasal spray, inhaled, eye drops }} '''Cromoglicate''' ([[International Nonproprietary Name|INN]]) (also referred to as '''cromolyn''' ([[USAN]]) or '''cromoglycate''' (former [[British Approved Name|BAN]])) is traditionally described as a [[mast cell stabilizer]], and is commonly marketed as the sodium salt '''sodium cromoglicate''' or '''cromolyn sodium'''. This drug prevents the release of [[inflammation|inflammatory]] chemicals such as [[histamine]] from [[mast cell]]s. ==Uses== It is available as a nasal spray (Rynacrom(UK), Nasalcrom, Prevalin (Netherlands)) to treat [[allergic rhinitis]], as an inhaler (Intal) for preventive management of [[asthma]], as [[eye drop]]s (Opticrom and Optrex Allergy (UK), Crolom) for [[allergic conjunctivitis]], or in an oral form (Gastrocrom) to treat [[mastocytosis]], [[dermatographic urticaria]] and [[ulcerative colitis]]<!-- see DrugBank link above-->. Sodium cromoglicate has also been shown to reduce symptoms of food allergies, including some cases of chronic migraines.{{Fact|date=February 2007}} ==Mechanism of action== "Cromolyn works because it prevents the release of mediators that would normally attract inflammatory cells and because it stabilizes the inflammatory cells."<ref>Werner's Pathophysiology page 224</ref> The underlying [[mechanism of action]] is not fully understood; for while cromoglicate stabilizes mast cells, this mechanism is probably not why it works in asthma.<ref name="rang">H. P. Rang et al, ''Pharmacology'', Fifth Edition. (2003) ISBN 0 443 07145 4</ref> Pharmaceutical companies have produced 20 related compounds that are equally or more potent at stabilising mast cells and none of them have shown any anti-asthmatic effect.<ref name="rang"/> It is more likely that these work by inhibiting the response of sensory C fibres to the irritant [[capsaicin]], inhibiting local axon reflexes involved in asthma, and may inhibit the release of preformed T cell cytokines and mediators involved in asthma. (see review by Garland, 1991) ==Allergic reactions== Allegic reactions may include severe rash internally and externally. It is known to somewhat inhibit [[chloride channels]] (37% +/- 7%) <ref>{{cite journal | quotes = | first = S | last = Heinke | coauthors = Szucs G, Norris A, Droogmans G, Nilius B | year = 1995 | month = August | title = Inhibition of volume-activated chloride currents in endothelial cells by chromones | journal = Br J Pharmacol. | volume = 115(8) | pages = 1393–8 | pmid = 8564197 }}</ref> and thus ''may'' inhibit the: * exaggerated neuronal reflexes triggered by stimulation of irritant receptors on sensory nerve endings (e.g. exercise-induced asthma) * release of preformed [[cytokines]] from several type of inflammatory cells ([[T cell]]s, [[Eosinophil granulocyte|eosinophils]]) in allergen-induced asthma Note: Another chemical (NPPB (5-nitro-2(3-phenyl) propylamino-benzoic acid)) was shown, in the same study, to be a more effective chloride channel blocker. Finally it may act by inhibiting calcium influx.<!-- see DrugBank link above--> Cromoglicate is classified as a [[chromone]]. ==References== <references/> {{Antidiarrheals, intestinal anti-inflammatory/anti-infective agents}} {{Nasal preparations}} {{Asthma and copd rx}} [[Category:Mast cell stabilizers]] {{pharma-stub}} [[de:Cromoglicinsäure]] [[it:Sodio cromoglicato]] [[pl:Kromoglikan dwusodowy]] [[pt:Cromoglicato]]