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Antiasthma Agents during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
The mechanisms of cromolyn sodium nedocromil are inhibition of mast cell degranulation and thus the release of the chemical mediators of anaphylaxis, and is taken by inhalation for asthma prophylaxis. Among 296 infants whose mothers took cromolyn sodium during the first trimester, the frequency of birth defects was not increased (Wilson, 1982a, b). Among infants born to 151 and 191 women who used cromolyn sodium during the first trimester, the frequency of congenital anomalies was not increased (Rosa, personal communication) (Schatz et al., 1997). The frequency of birth defects was not increased in an unpublished study that included 191 infants born to women who used cromolyn during the first trimester (Rosa, unpublished, Briggs et al., 2017).
Respiratory Diseases
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Aref T. Senno, Ryan K. Brannon
Cromolyn sodium is a nonsteroidal anti-inflammatory agent used for chronic management of asthma, not acute exacerbations (4 weeks for maximal benefit). There is no evidence of increased rates of congenital malformations with the use of cromolyn in pregnancy [19]; this is a safe drug in pregnancy, as is nedocromil.
The Effect of Anti-Asthmatic Drugs on Airway Hyperresponsiveness and Inflammation
Published in Devendra K. Agrawal, Robert G. Townley, Inflammatory Cells and Mediators in Bronchial Asthma, 2020
Following this initial observation on the effect of theophylline and sodium cromoglycate on airway inflammation and bronchial responsiveness, dose-response studies with theophylline, sodium cromoglycate, and nedocromil sodium in the same animal model have been performed. Theophylline significantly inhibited the endotoxin-induced airway inflammation and the increase in 5-HT responsiveness at therapeutic and even lower serum concentrations. Pretreatment with either nedocromil or cromoglycate did not prevent the endotoxin-induced airway inflammation and increase in bronchial responsiveness.
Bayesian approaches to variable selection in mixture models with application to disease clustering
Published in Journal of Applied Statistics, 2023
The Childhood Asthma Management Program (CAMP) is a triple-blinded randomized clinical trial originally designed to evaluate whether treatment with either an inhaled corticosteroid (budesonide) or an inhaled noncorticosteroid drug (nedocromil) safely produces an improvement in lung growth when compared with treatment for symptoms only. The primary outcome of CAMP is lung function measured by forced expiratory volume in 1 s (FEV1). Participants recruited to the trial were also followed by three phases of observational follow-up lasting 13 years. Both trial and observational follow-up included an annual prebronchodilator and postbronchodilator spirometry test (during which FEV1 data were collected) as part of the protocol. At baseline, 1041 children were randomly assigned to receive 200 μg of budesonide (311 children), 8 mg of nedocromil (312 children), or placebo (418 children) twice daily. These participants were from 5 to 12 years of age with mild-to-moderate asthma and were treated for four to six years. The trial found that the anti-inflammatory medications did not have a better long-term effect than placebo on lung function growth [7]. The trial also assessed differences between treatment groups regarding airway responsiveness, morbidity and physical growth etc. More details about the design of this study can be found in [6].
Challenges with chromone as a privileged scaffold in drug discovery
Published in Expert Opinion on Drug Discovery, 2018
Carlos F. M. Silva, Vasco F. Batista, Diana C. G. A. Pinto, Artur M. S. Silva
This scaffold’s biological potential, allied to a low mammalian toxicity, prompted the development of several chromone-based drugs with distinct applications, particularly as anti-inflammatory agents (Figure 1) [5,6,8]. Disodium cromoglycate (1) is one such example, used as a mast cell stabilizer for the treatment of allergic rhinitis, asthma, and allergic conjunctivitis. Its commercialization faced some challenges, since the response of asthmatics to cromoglycate therapy is highly variable and it must be administrated by inhalation due to poor oral absorption. Likewise, nedocromil sodium (2) is marketed for the prevention of wheezing, shortness of breath, and other breathing problems caused by asthma. Also, flavocoxid, an extract containing the naturally occurring compound baicalin (3) as one of its major APIs, is an anti-inflammatory drug acting in the molecular pathways responsible for the production of both prostaglandins and leukotrienes, through the dual inhibition of COX and 5-LOX [9]. Finally, iguratimod (4) is a disease-modifying anti-rheumatic drug, accumulating its anti-inflammatory effects with the ability to inhibit immunoglobulin and cytokine production and even inducing an anabolic effect on bone metabolism [10].
Chromones: privileged scaffolds for the production of multi-target-directed-ligand agents for the treatment of Alzheimer’s disease
Published in Expert Opinion on Drug Discovery, 2018
Carlos F. M. Silva, Diana C. G. A. Pinto, Artur M. S. Silva
As mentioned earlier, chromones are widely known for their huge number of biological activities emphasizing their anti-inflammatory activity, with two compounds already marketed as anti-inflammatory drugs for the treatment of asthma, namely sodium cromoglicate and nedocromil sodium [11]. However, these compounds are also emerging as potential MTDLs for the treatment of AD, since they have been associated to several beneficial effects toward different molecular hallmarks of the AD, such as the decrease of the cholinergic levels, the formation, and aggregation of Aβ, metal levels regulation, among others. Therefore, the understanding of the chromones’ optimal structural characteristics related to their beneficial effects would constitute crucial progress for further synthesis.