Cromolyn Sodium: A Review of Mechanisms and Clinical Use in Asthma

1987 ◽  
Vol 21 (1) ◽  
pp. 22-35 ◽  
Author(s):  
Shirley Murphy ◽  
H. William Kelly
Keyword(s):  
Behavioral Problems ◽  
Cell Types ◽  
Cromolyn Sodium ◽  
Inhalation Technique ◽  
Chronic Asthma ◽  
Asthmatic Patients ◽  
Steroid Dependent ◽  
Mediators Of Inflammation ◽  
Metered Dose ◽  
Exercise Induced

The cellular and clinical pharmacology of cromolyn sodium are reviewed. Cromolyn sodium inhibits the release of mediators of inflammation, induced by specific antigens as well as nonspecific mechanisms, such as exercise, from mast cells. Cromolyn may also inhibit the activity of other cell types that produce inflammation. It is the only antiasthmatic that blocks both early and late asthmatic responses induced by allergen inhalation and exercise. Consequently, cromolyn therapy can block the increase in bronchial hyperreactivity induced by chronic allergen exposure. Cromolyn is effective for controlling the symptoms of mild to moderate chronic asthma in 60 to 70 percent of patients. In comparative studies, cromolyn has been as effective as theophylline for controlling symptoms of chronic asthma with fewer side effects, and may be particularly suited for asthmatic patients with learning or behavioral problems. The combination of theophylline and cromolyn is often more effective than either agent alone. Because of the convenience of administration, cromolyn is preferred over theophylline for exercise-induced asthma. Cromolyn may allow the corticosteroid dosage to be reduced in severe steroid-dependent asthmatics, but it is primarily indicated for the prophylaxis of mild to moderate disease. Adverse reactions to cromolyn are uncommon to rare. Cromolyn is now available in a Spinhaler, a metered-dose aerosol, and a nebulizer solution. If taken properly all preparations appear to be equally effective. Attention to proper inhalation technique and appropriate education of the patient is essential to ensure a good outcome with cromolyn.

Nedocromil Sodium

1993 ◽  
Vol 27 (5) ◽  
pp. 599-606 ◽  
Author(s):  
Roy C. Parish ◽  
Lisa J. Miller
Keyword(s):  
Allergic Rhinitis ◽  
English Language ◽  
Nedocromil Sodium ◽  
Individual Response ◽  
Chronic Asthma ◽  
Medline Search ◽  
Therapeutic Benefits ◽  
Steroid Dependent ◽  
Exercise Induced ◽  
Better Than

OBJECTIVE: To summarize the available pharmacokinetic and pharmacologic data on nedocromil sodium and to present representative clinical trials of this new agent in both mild-to-moderate and severe chronic asthma and allergic rhinitis. Adverse effects are reviewed. DATA SOURCES: A MEDLINE search was used to identify pertinent literature, excluding reviews and foreign-language articles. All available English-language studies were reviewed. DATA EXTRACTION: Pivotal and representative studies are discussed relating to the following issues: Pharmacology and pharmacokinetics, management of patients with non-steroid-dependent and steroid-dependent asthma, comparison with sodium cromoglycate (cromolyn), comparison with inhaled beclomethasone dipropionate, management of exercise-induced asthma, use in children with asthma, and use in allergic rhinitis. DATA SYNTHESIS: Nedocromil sodium is chemically grossly unrelated to cromolyn but has similar pharmacology, pharmacokinetics, and therapeutic benefits. Although ineffective in relieving acute asthma attacks, nedocromil appears to be superior to placebo in lessening the severity of chronic asthma and protecting against allergen-induced asthma when taken as chronic prophylaxis. Single doses attenuate exercise-induced asthma. It is also effective in the management of allergic rhinitis. Results have varied when nedocromil has been compared with cromolyn or inhaled beclomethasone. Studies to date indicate that, overall, nedocromil is not significantly better than cromolyn and is no better than or is inferior to inhaled beclomethasone, although individual response appears to be variable, with no identifiable predictive factors. CONCLUSIONS: Individual patients may receive marked improvement from nedocromil therapy, but there are no factors that identify which patients will respond. Nedocromil may be particularly useful in adults who frequently fail to respond to cromolyn.

scholarly journals Association of Asthma Control and Metered-Dose Inhaler Use Technique among Adult Asthmatic Patients Attending Outpatient Clinic, in Resource-Limited Country: A Prospective Study

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Bezie Kebede ◽  
Girma Mamo ◽  
Abebaw Molla
Keyword(s):  
Asthma Control ◽  
Statistical Significance ◽  
Study Patient ◽  
Dose Inhaler ◽  
Inhalation Technique ◽  
Metered Dose Inhaler ◽  
Asthmatic Patients ◽  
Ordinal Logistic Regression Analysis ◽  
Metered Dose ◽  
Adult Asthmatic

Asthma is a heterogeneous disease which is characterized by chronic airway inflammation. It is a common chronic respiratory disease affecting 1–18% of population in different countries. It can be treated mainly with inhaled medications in several forms, including pressurized metered-dose inhaler (MDI). Patients encountered difficulty in using inhaler devices even after repeated demonstration and/re-evaluation. This could highly compromise patient treatment outcome/asthma control. To evaluate relationship between MDI use technique and asthma control among adult asthmatic patients who attend respiratory clinic in Jimma University Medical Center (JUMC), Southwest Ethiopia. A prospective observational study was conducted from March to August 22, 2018. All adult asthmatic patients who met the inclusion criteria were included in the study. Patient baseline assessment was conducted (patient demography, inhalation technique, adherence, and asthma control status). Inhalation technique was obtained using a standard checklist of steps recommended in National Institute of Health (NIH) guidelines. Patient adherence using asthma inhalation test and asthma control status was assessed by 2017 GINA guideline. Independent predictors of outcome were identified, strength of association between dependent and independent variables was determined by using ordinal logistic regression analysis, and statistical significance was considered at P<0.05. One hundred forty patients were included in the analysis. Among these, 26 (18.4%) patients were controlled, 65 (46.1%) partially controlled, and 35% uncontrolled. Proportion of patients with uncontrolled asthma were higher among inefficient as compared to efficient, whereas patients with controlled asthma were higher among efficient as compared to inefficient. Asthma control status is significantly associated with inhalation technique (P=0.006). Since most of the patients were inefficient and it is significantly associated with asthma control status, the hospital tried to adopt video MDI teaching program, and the patient should ask healthcare professionals how to take medication and they should bring their device to receive demonstration during visit. Health professionals should re-evaluate the patient during their hospital visit and encourage bringing their device to give demonstration.

scholarly journals The Effect of Cromolyn Sodium and Nedocromil Sodium Administered by A pressurized Aerosol with A spacer Device on Exercise-Induced Asthma in Children

1994 ◽  
Vol 3 (7) ◽  
pp. S35-S37 ◽  
Author(s):  
F. M. de Benedictis ◽  
G. Tuteri ◽  
A. Niccoli ◽  
D. Mezzetti ◽  
L. Rossi ◽  
...  
Keyword(s):  
Cromolyn Sodium ◽  
Nedocromil Sodium ◽  
Controlled Study ◽  
Dose Inhaler ◽  
Metered Dose Inhaler ◽  
Double Blind ◽  
Asthmatic Children ◽  
Metered Dose ◽  
Exercise Induced ◽  
Better Than

To compare the effectiveness of cromolyn sodium (CS) (10 mg) and nedocromil sodium (NS) (4 mg) administered by a metered dose inhaler (MDI) with a spacer device in preventing exercise-induced asthma (EIA), eight asthmatic children with EIA were studied in a randomized double-blind, cross-over, placebo-controlled study, CS and NS provided significant, comparable protection from EIA and both were better than placebo. We conclude that CS and NS administered by a pressurized aerosol with a spacer device provide equal protection against EIA in children.

scholarly journals Skills in Handling Turbuhaler, Diskus, and Pressurized Metered-Dose Inhaler in Korean Asthmatic Patients

2011 ◽  
Vol 3 (1) ◽  
pp. 46 ◽  
Author(s):  
Sang Min Lee ◽  
Yoon-Seok Chang ◽  
Cheol-Woo Kim ◽  
Tae-Bum Kim ◽  
Sang-Heon Kim ◽  
...  
Keyword(s):  
Dose Inhaler ◽  
Metered Dose Inhaler ◽  
Asthmatic Patients ◽  
Metered Dose ◽  
Pressurized Metered Dose Inhaler

scholarly journals Asthma and COVID-19: who wins the contested territory of the lower airways?

2021 ◽  
Vol 10 (12) ◽  
pp. e17101220110
Author(s):  
Taís de Lima e Fraga ◽  
Waldemar de Paula Junior ◽  
Marileia Chaves Andrade
Keyword(s):  
Target Cells ◽  
Chronic Asthma ◽  
Th2 Response ◽  
Angiotensin Converting Enzyme 2 ◽  
Asthmatic Patients ◽  
Coronavirus Infection ◽  
Inflammatory Profile ◽  
Limited Possibility ◽  
Pro Inflammatory Cytokines

Among the numerous published studies on COVID-19 in a pandemic year, few listed asthma as a comorbidity, making it therefore difficult to draw any solid conclusions. The respiratory allergy and controlled exposures to allergens are associated with significant reductions in the expression of angiotensin-converting enzyme 2 (ACE2), receptor for SARS-CoV-2 entry into human cells. There is a hypothesis that patients with chronic asthma, due to the type 2 inflammatory profile, may be potentially resistant to developing a severe clinical course of COVID-19. The low IFN-g-mediated response in the respiratory tract of asthmatic patients could limit ACE2 expression in the target cells of SARS-CoV-2 infection. The inflammatory profile of the airways in patients with chronic asthma is mainly related to a Th2 response in type-2 asthma, with production of IL-4, IL-13 and IL-5, presenting antagonistic relationship with pro-inflammatory cytokines such as IFN-g, produced at high levels in severe COVID-19. Published studies, for the most part, are retrospective and may have loss of information or present material with limited possibility for more robust and conclusive analysis. It is important to discuss how patients with atopic or nonatopic asthma seem to protect themselves from new coronavirus infection and how asthma affects COVID-19 and the course of the disease, since there is no increased mortality in asthmatic patients with COVID-19 compared to non-asthmatic patients.

scholarly journals The Challenge of Delivering Therapeutic Aerosols to Asthma Patients

ISRN Allergy ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-17 ◽  
Author(s):  
Federico Lavorini
Keyword(s):  
Asthma Management ◽  
Dose Inhaler ◽  
Inhalation Technique ◽  
Management Guidelines ◽  
Inhaler Device ◽  
Peripheral Airways ◽  
Metered Dose ◽  
Asthma Patients ◽  
Patient Noncompliance ◽  
Inhaler Devices

The number of people with asthma continues to grow around the world, and asthma remains a poorly controlled disease despite the availability of management guidelines and highly effective medication. Patient noncompliance with therapy is a major reason for poor asthma control. Patients fail to comply with their asthma regimen for a wide variety of reasons, but incorrect use of inhaler devices is amongst the most common. The pressurised metered-dose inhaler (pMDI) is still the most frequently used device worldwide, but many patients fail to use it correctly, even after repeated tuition. Breath-actuated inhalers are easier to use than pMDIs. The rationale behind inhaler choice should be evidence based rather than empirical. When choosing an inhaler device, it is essential that it is easy to use correctly, dosing is consistent, adequate drug is deposited in both central and peripheral airways, and that drug deposition is independent of airflow. Regular checking of inhalation technique is crucial, as correct inhalation is one of the cornerstones of successful asthma management.

Sign in / Sign up

Export Citation Format

Share Document