Cromones

Question 1

Name 2 cromones.

Answer 1

1) Sodium Cromoglicate

2) Nedocromil Sodium

Question 2

1) What are cromones used for?
2) What treatment are cromones usually less effective than?
3) What proportion of patients actually benefit from treatment with cromones?
4) Why are cromones of no use in acute asthma attacks?

Answer 2

1) To prevent asthma attacks as prophylactic agents infield to moderate antigen, pollutant and exercise induced asthma.
2) ICS.
3) About 1/3.
4) Because they have no bronchodilator effect.

Question 3

Except from asthma, what other 2 conditions can Cromones be used for?

Answer 3

1) As nasal inhalants in seasonal allergic rhinitis.

2) Ophthalmic solutions to treat allergic conjunctivitis.

Question 4

Name the 4 main mechanisms of action of Cromones.

Answer 4

1) Mast cell stabilisation (may protect against immediate bronchoconstriction induced by allergens, exercise or cold air).
2) Inhibition of sensory C-fibre neutrons (responsible for protection against bronchoconstriction produced by irritants such as sulphur dioxide).
3) Inhibition of accumulation of eosinophils in the lungs and reduced activation of eosinophils, neutrophils and macrophages in inflamed lung tissue (important to prevent late phase response to allergens and the development of bronchial hyperactivity).
4) Inhibition of B cell switching to IgE production.

Question 5

1) How many doses will be required to prevent the early phase bronchoconstrictor response to an allergen?
2) How much treatment is required ro block the late-phase reaction?

Answer 5

1) a single dose.

2) 1-2 months of treatment.

Question 6

Why are the 2 cromones at the site of action of the bronchial mucosa?

Answer 6

Because they are highly ionised and poorly absorbed across biological membranes.

Question 7

List 3 unwanted effects of Cromones.

Answer 7

1) Cough, wheeze and throat irritation mat be provoked transiently following inhalation.
2) Headache.
3) Nausea, vomiting, dyspepsia and abdominal pain with Nedocromil sodium.