Mast Cell Stabilizers

Prototype and Other Medications

• Prototype Mast Cell Stabilizer: Cromolyn

Expected Pharmacologic Action

• Mechanism: Suppresses inflammation similar to corticosteroids.

• Prevention of Inflammation:

  • Inhibits release of leukotrienes and histamine which mediate inflammation.

  • Prevents stimulation of inflammatory response by white blood cells (leukocytes and eosinophils).

  • Decreases inflammation and edema in airways.

• Effects: Does not cause bronchodilation.

Adverse Drug Reactions

• Cromolyn is considered one of the safest antiasthma medications.

• Minimal Side Effects:

  • Cough or bronchospasm may occur in fewer than 1 out of 10,000 clients.

Interventions

• Contraindications: Not for clients with previous allergic reactions to cromolyn.

• Administration Guidelines:

  • Use a power-driven nebulizer.

  • Initial dosage: 20 mg four times daily.

  • Maintain lowest effective dosage thereafter.

  • To prevent Exercise-Induced Bronchospasm (EIB), administer 10 to 15 minutes before activity, no sooner than 1 hour prior.

  • For seasonal allergies, take cromolyn prior to exposure (e.g., yard work).

Client Instructions

• Usage:

  • Take as prescribed for prevention of asthma exacerbations.

  • Not effective for acute asthma attacks.

  • Therapeutic effects may take several weeks to manifest.

• Safety Alert:

  • Seek immediate medical attention for:

    • Sudden rash

    • Swelling of mouth or throat

    • Wheezing after use.

Contraindications and Precautions

• Contraindications: Allergic reactions to cromolyn.

Interactions

• No known medication or food interactions with mast cell stabilizers.