KROMOLIN-NATRIY (Cromolyn Sodium; synonym: intal, Dinatrium Cromoglicicum, Disodium Cromoglycate, Intal, Lomudal) — the desensibilizing means. Disodium salt 1,3-bis-(2-karboksikhromonil-5-oksi) 2 of oxypropane:
Inodorous white crystal powder, bitterish taste. Let's easily dissolve in water.
To. - the N has ability to prevent degranulation of mast cells and allocation from them biologically active agents (a histamine, bradikinin, serotonin, prostaglandins, etc.) which cause edematization, a hyperemia, a bronchospasm and some other manifestations of allergic reactions of immediate type. Action To. - N on mast cells it is not specific since he prevents their degranulation caused not only immune factors (reaction antigen — an antibody on a surface of cells), but also influence of a number of substances (a dextran, a phospholipase And) which belong to so-called releasers of a histamine. To. - the N does not influence cellular and humoral factors of immunity, does not break interaction of antigens with antibodies, has no antagonism to effect of mediator substances (a histamine, serotonin, etc.) and myotropic spasmolytic action.
Mechanism of action To. - N connect with his ability to reduce permeability of membranes of mast cells in relation to ions of Ca2+ that leads to oppression of sokratitelny ability of microfibrils of cytoplasm of mast cells and disturbance thereof process of degranulation of the last.
To. - the N is badly soaked up in went. - kish. a path, but it is well absorbed by mucous membranes of respiratory tracts. In an organism drug is not metabolized and removed in not changed view with urine and bile.
To. - N. apply at atopic and infectious and allergic forms of bronchial asthma, an allergic bronchitis and a pneumosclerosis with attacks of suffocation (especially in the presence of an allergic component). At prolonged use drug urezhat and facilitates asthmatic attacks, reduces the need for bronchial spasmolytics and glucocorticoids. Efficiency concerning bad asthmatic attacks To. the N does not possess.
Drug is used for inhalations in the form of capsular powder. Spraying of powder and inhalation make by means of a special pocket turboingalyator («Backs galleys») in which before inhalation place the capsule. During the pressing a cover of an inhaler the capsule is punctured, and its contents (powder) at a breath come to respiratory tracts. Full emptying of the capsule happens during four breaths.
Inhalations of drug are appointed daily, since 4 capsules a day (on 1 capsule every 6th hour). If necessary the dose is increased to 8 capsules a day (on 1 capsule every 3 hour). After improvement of a state the number of inhalations gradually reduce, selecting an individual maintenance dose. Effect of drug develops slowly. The maximum effect occurs usually in 2 — 4 weeks from an initiation of treatment. At drug withdrawal resuming of attacks is possible. In case of need To. - the N can appoint together with broncholitic means and glucocorticoids.
At use of drug sometimes there is cough and a short-term bronchospasm. For the prevention and elimination of cough recommend to drink a glass of water right after inhalation. For prevention of a bronchospasm inhalations of bronchial spasmolytics are shown (e.g., Isadrinum, an ortsiprenalin of sulfate). In some cases side effect To. - the N is shown by melkopapulezny rash, a small tortoiseshell and other symptoms of an allergy, including heavy anaphylactic reactions, napr, a Quincke's edema (see. Quincke hypostasis ) and acute anaphylaxis (cm).
To persons with diseases of a liver and kidneys drug is appointed with care. To pregnant women and children up to 5 years To. - N do not appoint.
Form of release: capsular, containing 0,02 g To. - N and on 0,1 mg of an izoprenalin of sulfate (Isadrinum). See also the Desensibilizing means .
Bibliography: F. I. mosquitoes, etc. Treatment of patients with bronchial asthma hro-moglikaty sodium, Klin, medical, t. 53, No. 2, page 94, 1975, bibliogr.; Brogden R. N., S p e i g b t T. M of a. Avery G. S. Sodium cromoglycate (cromolin sodium), Drugs, v. 7, p. 164, 1974, bibliogr.
V. K. Muratov.