Cromoglicate

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Cromoglicate
Systematic (IUPAC) name
5-(3-(6-carboxy-8-oxo-5,8-dihydronaphthalen-1-yloxy)
-2-hydroxypropoxy)-4-oxo-4H-chromene-2-carboxylic acid
Identifiers
CAS number 16110-51-3
ATC code R03BC01 R01AC01 A07EB01
PubChem 27686
DrugBank APRD00336
Chemical data
Formula C23H16O11 
Mol. mass 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 or cromolyn sodium. This drug prevents the release of inflammatory chemicals such as histamine from mast cells.

Contents

[edit] 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 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

"Cromolyn works because it prevents the release of mediators that would normally attract inflammatory cells and because it stabalizes the inflammatory cells."[1] 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.[2] 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.[2] It is more likely that these work by inhibiting the response of sensory C fibres to the irritant capsacin, 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)

[edit] Allergic reactions

Allegic reactions may include severe rash internally and externally.

It is known to somewhat inhibit chloride channels (37% +/- 7%) [3] 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 chromone.

[edit] References

  1. ^ Werner's Pathophysiology page 224
  2. ^ a b H. P. Rang et al, Pharmacology, Fifth Edition. (2003) ISBN 0 443 07145 4
  3. ^ 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.