Cromoglicate
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| Cromoglicate
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| 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 | |
| ATC code | R03 R01AC01 A07EB01 |
| PubChem | |
| DrugBank | |
| 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 |
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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.
Uses
It is available as a nasal spray (Rynacrom®(UK), Nasalcrom®) 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.
Mechanism of action
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. 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. 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)
Allergic reactions
Allegic reactions may include severe rash internally and externally.
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 chromone.
References
Antidiarrheals, intestinal anti-inflammatory/anti-infective agents (A07) | |
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| Intestinal anti-infectives | Antibiotics (Neomycin, Nystatin, Natamycin, Streptomycin, Polymyxin B, Paromomycin, Amphotericin B, Kanamycin, Vancomycin, Colistin, Rifaximin)
Sulfonamides (Phthalylsulfathiazole, Sulfaguanidine, Succinylsulfathiazole) other (Miconazole, Broxyquinoline, Acetarsol, Nifuroxazide, Nifurzide) |
| Intestinal adsorbents | Charcoal - Bismuth - Pectin - Kaolin - Crospovidone - Attapulgite - Diosmectite |
| Antipropulsives | Diphenoxylate - Opium - Loperamide - Difenoxin |
| Intestinal anti-inflammatory agents | corticosteroids acting locally (Prednisolone, Hydrocortisone, Prednisone, Betamethasone, Tixocortol, Budesonide, Beclometasone)
antiallergic agents, excluding corticosteroids (Cromoglicic acid) aminosalicylic acid and similar agents (Sulfasalazine, Mesalazine, Olsalazine, Balsalazide) |
| Antidiarrheal micro-organisms | Saccharomyces boulardii |
| Other antidiarrheals | Albumin tannate - Ceratonia - Racecadotril |
Decongestants and other nasal preparations (R01) | |
|---|---|
| Topical: sympathomimetics, plain | Cyclopentamine - Ephedrine - Phenylephrine - Oxymetazoline - Tetryzoline - Xylometazoline - Naphazoline - Tramazoline - Metizoline - Tuaminoheptane - Fenoxazoline - Tymazoline - Epinephrine |
| Topical: antiallergic agents, excluding corticosteroids | Cromoglicic acid - Levocabastine - Azelastine - Antazoline - Spaglumic acid - Thonzylamine - Nedocromil - Olopatadine |
| Topical: corticosteroids | Beclometasone - Prednisolone - Dexamethasone - Flunisolide - Budesonide - Betamethasone - Tixocortol - Fluticasone - Mometasone furoate - Triamcinolone - Ciclesonide |
| Topical: other nasal preparations | Calcium hexamine thiocyanate - Retinol - Ipratropium bromide - Ritiometan - Mupirocin - Hexamidine - Framycetin |
| Systemic use: Sympathomimetics | Phenylpropanolamine - Pseudoephedrine - Phenylephrine |
Drugs for obstructive airway diseases: asthma/COPD (R03) | |
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| Adrenergics, inhalants | Short acting β2-agonists: Salbutamol/Levosalbutamol • Fenoterol • Terbutaline Long acting β2-agonists (LABA): Bambuterol • Clenbuterol • Formoterol • Salmeterol other: Epinephrine • Isoproterenol • Orciprenaline |
| Glucocorticoids | Beclometasone • Budesonide • Ciclesonide • Fluticasone • Mometasone |
| Anticholinergics | Ipratropium • Tiotropium |
| Mast cell stabilizers | Cromoglicate • Nedocromil |
| Xanthines | Aminophylline • Theobromine • Theophylline |
| Leukotriene antagonists | Montelukast • Pranlukast • Zafirlukast |
| Combination products | Budesonide/formoterol • Fluticasone/salmeterol • Ipratropium/salbutamol |
de:Cromoglicinsäure
it:Sodio cromoglicato
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
