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From: kenc@islenet.UUCP (Ken Cribbs)
Newsgroups: net.med
Subject: Re: Cromolyn Eyedrops
Message-ID: <1503@islenet.UUCP>
Date: Thu, 15-Aug-85 19:24:11 EDT
Article-I.D.: islenet.1503
Posted: Thu Aug 15 19:24:11 1985
Date-Received: Tue, 20-Aug-85 08:36:21 EDT
References: <344@rti-sel.UUCP> <342@bbncc5.UUCP>
Distribution: net
Organization: Islenet Inc.,  Honolulu
Lines: 151

> > Cromolyn sodium has been used for a longer period of time, I believe,
> > in nosedrops. Does anyone out there have any experience with these
> > nosedrops, or know of any bad reactions/side effects to them? Better
> > still, is anyone familiar with the literature on cromolyn sodium and
> > its safety? Just what the heck IS cromolyn sodium, anyway? A friend
> > taking cortisone thought it was related somehow to cortisone.
> 
> Actually, cromolyn sodium has been used in an inhaler for the prophylaxis
> of asthmatic attacks for more than 15 years, with almost 10 years of
> U.S. experience.
> 
> Pharmacologically it is a rather interesting substance, a unique approach
> in the treatment of allergic syndromes: it prevents the release of
> histamine and other autacoids from certain mast cells when challenged by
> antigens.  So, it is unlike adrenalin and other sympathetic amines which
> have pharmacological effects opposite to those of histamine, and it is
> unlike antihistamines which block H1 histamine receptors on target cells.
> Finally, it is unlike corticosteroids which block the inflammatory
> responses induced by the release of such autacoids.  As you might expect
> from its mechanism of action, cromolyn is useful only in PREVENTING
> allergic reactions--it has no effect on the body's response once the
> autacoids have been released from the mast cells.  So, you take the drug
> precisely when you're NOT suffering from an acute attack of hay fever,
> asthma, or other allergies.
> 
> 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.  
> -- 
> /Steve Dyer
> {decvax,linus,ima,ihnp4}!bbncca!sdyer
> sdyer@bbnccv.ARPA

I'm an asthmatic (currently on daily steroid therapy... ) who
first tried cromolyn sodium shortly after its first major
promotion in the medical-advertising 4-color full-page ads
about 11 years ago.  I used the inhaled powder form of the
drug, which I understand has some pharmacokinetic differences
from the "new" solutions (such as the form used in ophthalmic
preparations); but, potential differences notwithstanding, I
thought I should relate my experience with the drug:
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.
I underwent arteriography three times in attempts to define my
"lesion"--almost exsanguinated when the radiology resident
forgot to keep pressure on my punctured femoral artery, and
I lost so much blood that I was transfused with 2 units--
but no definitive anatomic obstruction was ever documented.
The cromolyn was stopped, and so did my symptoms.  I was
discharged with a diagnosis of "peripheral arteriospasm of
unknown etiology."
Before anyone else mentions it, I'll be the first to admit that
my own personal experience falls far short of the prospective,
randomized double-blind research documentation needed to establish
proximate causation...
and I have no particular axes to grind... I'm *not* suggesting 
that the cromolyn caused my problem (which never manifested it-
self again)--
my only purpose in posting this reply is to learn whether anyone
else has experienced or heard of similar vasospastic phenomena
occurring after using the drug.  The objective-medical-research
portion of my psyche continues to reject the suggestion that I
experienced an adverse reaction; but the subjective/personal
portion still harbors gnawing questions...
Me ke nui mahalo [means "thanks a lot..."]

--Ken Cribbs
islenet/honolulu
Subject: Re: Cromolyn Eyedrops
Newsgroups: net.med
Distribution: net
References: <344@rti-sel.UUCP> <342@bbncc5.UUCP>

> > Cromolyn sodium has been used for a longer period of time, I believe,
> > in nosedrops. Does anyone out there have any experience with these
> > nosedrops, or know of any bad reactions/side effects to them? Better
> > still, is anyone familiar with the literature on cromolyn sodium and
> > its safety? Just what the heck IS cromolyn sodium, anyway? A friend
> > taking cortisone thought it was related somehow to cortisone.
> 
> Actually, cromolyn sodium has been used in an inhaler for the prophylaxis
> of asthmatic attacks for more than 15 years, with almost 10 years of
> U.S. experience.
> 
> Pharmacologically it is a rather interesting substance, a unique approach
> in the treatment of allergic syndromes: it prevents the release of
> histamine and other autacoids from certain mast cells when challenged by
> antigens.  So, it is unlike adrenalin and other sympathetic amines which
> have pharmacological effects opposite to those of histamine, and it is
> unlike antihistamines which block H1 histamine receptors on target cells.
> Finally, it is unlike corticosteroids which block the inflammatory
> responses induced by the release of such autacoids.  As you might expect
> from its mechanism of action, cromolyn is useful only in PREVENTING
> allergic reactions--it has no effect on the body's response once the
> autacoids have been released from the mast cells.  So, you take the drug
> precisely when you're NOT suffering from an acute attack of hay fever,
> asthma, or other allergies.
> 
> 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.  
> -- 
> /Steve Dyer
> {decvax,linus,ima,ihnp4}!bbncca!sdyer
> sdyer@bbnccv.ARPA

I'm an asthmatic (currently on daily steroid therapy... ) who
first tried cromolyn sodium shortly after its first major
promotion in the medical-advertising 4-color full-page ads
about 11 years ago.  I used the inhaled powder form of the
drug, which I understand has some pharmacokinetic differences
from the "new" solutions (such as the form used in ophthalmic
preparations); but, potential differences notwithstanding, I
thought I should relate my experience with the drug:
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.
I underwent arteriography three times in attempts to define my
"lesion"--almost exsanguinated when the radiology resident
forgot to keep pressure on my punctured femoral artery, and
I lost so much blood that I was transfused with 2 units--
but no definitive anatomic obstruction was ever documented.
The cromolyn was stopped, and so did my symptoms.  I was
discharged with a diagnosis of "peripheral arteriospasm of
unknown etiology."
Before anyone else mentions it, I'll be the first to admit that
my own personal experience falls far short of the prospective,
randomized double-blind research documentation needed to establish
proximate causation...
and I have no particular axes to grind... I'm *not* suggesting 
that the cromolyn caused my problem (which never manifested it-
self again)--
my only purpose in posting this reply is to learn whether anyone
else has experienced or heard of similar vasospastic phenomena
occurring after using the drug.  The objective-medical-research
portion of my psyche continues to reject the suggestion that I
experienced an adverse reaction; but the subjective/personal
portion still harbors gnawing questions...
Me ke nui mahalo [means "thanks a lot..."]

--Ken Cribbs
islenet/honolulu