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From: sdyer@bbncc5.UUCP (Steve Dyer)
Newsgroups: net.med
Subject: Re: Cromolyn Eyedrops
Message-ID: <415@bbncc5.UUCP>
Date: Sun, 18-Aug-85 01:04:41 EDT
Article-I.D.: bbncc5.415
Posted: Sun Aug 18 01:04:41 1985
Date-Received: Tue, 20-Aug-85 06:50:30 EDT
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Organization: Bolt Beranek and Newman, Cambridge, MA
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> > Cromolyn seems to be well tolerated, with rare reports of irritation
> > and even rarer incidences of individual hypersensitivity to the drug.
> > Long term studies haven't found any remarkable side effects.  
> 
> Within four days of starting cromolyn therapy I developed a
> rather alarming problem--significant vasospasm of the median and
> radial arteries of my left upper extremity, resulting in a blue,
> "cold" left hand, quite a bit of pain, and significant concern
> on the part of a team of peripheral vascular surgeons as to the
> *possibility* that my problem was causally related to the new
> cromolyn therapy...

From my reading of the literature on cromolyn, this reaction hasn't been
reported as a common side-effect.  There are a couple of clinicians here
who may want to contribute their own opinions.  First and foremost, it's
important to distinguish between an individual's reaction to drug therapy
and the general experience gained from a drug's use which would guide its
administration.  Although your experience "proves" nothing for the general
populace, given the drug's record of safety over 15 years, you yourself are
another matter.  It is entirely reasonable to be suspicious of the link
between cromolyn and your vasospasm, and any reasonable doctor would not
ever administer it to you again.  Of course, it might indeed have been a
coincidence, but prudence would argue against testing this in your case
(vasospasm being a sufficiently undesirable and potentially dangerous
syndrome to treat.)  Consideration of an individual's idiosyncratic response
to drug therapy weighs far more heavily in deciding upon therapy than any
statistical data on large groups.

I noted a sense of embarassment in your comments, that somehow your
sentiments didn't fit in with the tenor of the "anti-faddists" who have
been responding to Stanions and Stoll, etc.  Not at all.  It is expected
that there will be individuals who respond to therapy remarkably
differently from the norm observed in clinical practice.  That doesn't make
them "wrong"!  The key difference is in the consideration of each
individual's reaction to derive a model of what the therapy can be
expected to produce.  If vasospasm were noticed as a side-effect which
occurred more frequently in the population being treated, then that fact
would have to be weighed against the possible benefit to each individual
patient being considered for this therapy.  If there were no significant
increase in vasospasm compared to the general populace, then a report like
yours would probably be chalked up to individual idiosyncracy.  There's a
very good chance, however, that a report was made to the drug manufacturer
for tracking.
-- 
/Steve Dyer
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