Cromoglicate

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Cromoglicate
Systematic (IUPAC) name
5-[3-(2-carboxy-4-oxo-chromen-6-yl) oxy-2-hydroxy-propoxy]- 4-oxo-chromene-2-carboxylic acid
Identifiers
CAS number	16110-51-3
ATC code	R03BC01
PubChem	27686
DrugBank	APRD00336
Chemical data
Formula	C23H16O11
Mol. weight	468.367 g/mol
Pharmacokinetic data
Bioavailability	1%
Metabolism	?
Half life	1.3 hours
Excretion	?
Therapeutic considerations
Pregnancy cat.	?
Legal status	inhaler POM, eye OTC(UK)
Routes	topical: oral, nasal spray, inhaled, eye drops

Cromoglicate (INN) (also referred to as cromolyn (USAN) or cromoglycate (former BAN)) is traditionally described as a mast cell stabilizer, and is commonly marketed as the sodium salt sodium cromoglicate. This drug prevents the release of inflammatory chemicals such as histamine from mast cells.

[edit] Uses

It is available as a nasal spray (Rhynacrom®(UK), Nasalcrom®) to treat allergic rhinitis, as an inhaler (Intal®) to treat asthma, as eye drops (Opticrom® and Optrex Allergy® (UK), Crolom®) for allergic conjunctivitis, or in an oral form (Gastrocrom®) to treat mastocytosis, dermatographic urticaria and ulcerative colitis.

Sodium cromoglicate has also been shown to reduce symptoms of food allergies, including some cases of chronic migraines.^{[citation needed]}

[edit] Mechanism of action

The underlying mechanisms of action are not fully understood; for while cromoglicate stabilizes mast cells, this mechanism is probably not why it works in asthma.^{[citation needed]} 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.^{[citation needed]}

It is known to somewhat inhibit chloride channels (37% +/- 7%) ^[1] 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 cells, 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.

Cromoglicate is classified as a cromone.

[edit] References

1. ^ Heinke, S, Szucs G, Norris A, Droogmans G, Nilius B (August 1995). "Inhibition of volume-activated chloride currents in endothelial cells by chromones". Br J Pharmacol. 115(8): 1393-8. PMID 8564197.

Medications commonly used in asthma and COPD (primarily R03) edit
Anticholinergics:	Ipratropium, Tiotropium
Short acting β2-agonists:	Salbutamol, Terbutaline
Long acting β2-agonists (LABA):	Clenbuterol, Formoterol, Salmeterol
Corticosteroids:	Beclometasone, Budesonide, Fluticasone
Leukotriene antagonists:	Montelukast, Pranlukast, Zafirlukast
Xanthines:	Aminophylline, Theobromine, Theophylline
Mast cell stabilizers:	Cromoglicate, Nedocromil
Combination products:	Budesonide/formoterol, Fluticasone/salmeterol, Ipratropium/salbutamol