In addition to their inhibition of mediator release, some of these drugs also inhibit the chemotaxis of eosinophils at the site of application (i.e., ocular tissue).54 In lung tissue, pretreatment with the mast cell stabilizers cromolyn and ne-docromil blocks the immediate and delayed bronchocon-strictive reactions induced by the inhalation of antigens. These drugs also attenuate the bronchospasm associated with exercise, cold air, environmental pollutants, and certain drugs (aspirin). However, the mast cell stabilizers do not have intrinsic bronchodilator, antihistamine, anticholinergic, vasoconstrictor, or glucocorticoid activity, and, when delivered by inhalation at the recommended dose, have no known therapeutic systemic activity. The structures, chemical properties, pharmacological profiles, and dosage data for these agents are provided in the monographs that follow.
Cromolyn Sodium. Cromolyn sodium, disodium 1,3-bis(2-carboxychromon-5-yloxy)-2-hydroxypropane (Intal), is a hygroscopic, white, hydrated crystalline powder that is soluble in water (1:10). It is tasteless at first but leaves a very slightly bitter aftertaste. The pK of cromolyn is 2. It is available as a solution for a nebulizer, an aerosol spray, a nasal solution, an ophthalmic solution, and an oral concentrate.
Nebulized and aerosol cromolyn has been used for prophylactic management of bronchial asthma and prevention of exercise-induced bronchospasm.52 Cromolyn nasal solution is used for the prevention and treatment of allergic rhinitis, and oral concentrate is used to treat the histaminic symptoms of mastocytosis (diarrhea, flushing, headaches, vomiting, urticaria, abdominal pain, nausea, and itching). Topical cro-molyn (eye drops) is used to treat allergic conjunctivitis and keratitis. In the treatment of asthma, cromolyn efficacy is manifested by decreased severity of clinical symptoms, or need for
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