Cromolyn sodium MCQs With Answer

Cromolyn sodium MCQs With Answer

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Cromolyn sodium MCQs With Answer: This focused set of 30 MCQs is crafted for B.Pharm students to build a strong grasp of cromolyn sodium — a chromone-class mast cell stabilizer used in prophylaxis of asthma, exercise-induced bronchospasm, allergic rhinitis and allergic conjunctivitis. Questions cover mechanism of action, clinical indications, inhalation/nasal/ophthalmic formulations, pharmacokinetics, adverse effects, patient counseling, and exam-relevant pharmaceutics. Emphasis is on clinical pharmacology, formulation differences, safety, and therapeutic monitoring to reinforce both theory and application in pharmacy practice. Clear explanations will aid revision and critical thinking. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. What is the primary pharmacological action of cromolyn sodium?

  • Beta-2 adrenergic receptor agonism
  • Inhibition of cyclooxygenase enzymes
  • Stabilization of mast cell membranes preventing mediator release
  • Anticholinergic bronchodilation

Correct Answer: Stabilization of mast cell membranes preventing mediator release

Q2. Cromolyn sodium is NOT appropriate for which of the following clinical situations?

  • Prophylaxis of exercise-induced bronchospasm
  • Chronic maintenance therapy for mild asthma
  • Immediate relief of an acute severe asthma attack
  • Topical treatment of allergic conjunctivitis

Correct Answer: Immediate relief of an acute severe asthma attack

Q3. Which of the following formulations of cromolyn sodium are commonly used in allergic airway disease?

  • Intravenous infusion and transdermal patch
  • Oral immediate-release tablets only
  • Inhalation solution (nebulizer) and intranasal spray
  • Subcutaneous depot injection

Correct Answer: Inhalation solution (nebulizer) and intranasal spray

Q4. When used for long-term control of asthma, therapeutic improvement with cromolyn sodium typically appears after:

  • Within seconds
  • Minutes
  • Days to weeks
  • Several months only

Correct Answer: Days to weeks

Q5. The most common adverse effects associated with inhaled cromolyn sodium are:

  • Systemic hypertension and tachycardia
  • Local airway irritation, cough, and throat discomfort
  • Severe renal toxicity
  • Marked hepatotoxicity

Correct Answer: Local airway irritation, cough, and throat discomfort

Q6. Regarding systemic absorption after inhalation, cromolyn sodium is best described as having:

  • High oral bioavailability and extensive systemic effects
  • Marked hepatic first-pass activation
  • Minimal systemic absorption with primarily local airway action
  • Prolonged systemic accumulation after single dose

Correct Answer: Minimal systemic absorption with primarily local airway action

Q7. Routine therapeutic drug monitoring (serum levels) is required for cromolyn sodium therapy.

  • True — serum levels guide dosing
  • False — routine serum monitoring is not required
  • True — peak and trough must be measured weekly
  • False — monitoring of liver enzymes replaces serum levels

Correct Answer: False — routine serum monitoring is not required

Q8. Which class of drug shows a clinically important pharmacokinetic interaction with cromolyn sodium?

  • Strong CYP3A4 inhibitors
  • MAO inhibitors
  • No significant drug interactions are generally reported
  • Potent CYP2D6 substrates

Correct Answer: No significant drug interactions are generally reported

Q9. Cromolyn sodium primarily prevents the release of which mediator from mast cells?

  • Insulin
  • Histamine
  • Adenosine triphosphate (ATP)
  • Thyroxine (T4)

Correct Answer: Histamine

Q10. For prophylaxis of exercise-induced bronchospasm, cromolyn sodium should be administered approximately how long before exercise?

  • Immediately after exercise
  • 10–15 minutes before exercise
  • 2–3 hours before exercise
  • Only at bedtime

Correct Answer: 10–15 minutes before exercise

Q11. Cromolyn sodium is classified chemically as which type of compound?

  • Beta-lactam antibiotic
  • Chromone (chromone derivative) — mast cell stabilizer
  • Long-acting beta-agonist
  • Macrolide antibiotic

Correct Answer: Chromone (chromone derivative) — mast cell stabilizer

Q12. Is cromolyn sodium considered safe for use in pediatric patients?

  • No — contraindicated in children under 12
  • Yes — it can be used in children, including younger pediatric age groups
  • Only topical ocular use is allowed in children
  • Use in children requires continuous ECG monitoring

Correct Answer: Yes — it can be used in children, including younger pediatric age groups

Q13. Which ocular condition is appropriately treated with ophthalmic cromolyn sodium?

  • Bacterial conjunctivitis
  • Allergic conjunctivitis
  • Cataract prevention
  • Glaucoma

Correct Answer: Allergic conjunctivitis

Q14. At the cellular level, cromolyn sodium stabilizes mast cells by interfering with:

  • DNA replication in mast cells
  • Calcium-dependent degranulation and mediator release
  • Adrenergic receptor synthesis
  • Mitochondrial ATP production only

Correct Answer: Calcium-dependent degranulation and mediator release

Q15. Which statement best describes systemic adverse effects of inhaled cromolyn sodium?

  • Common severe systemic organ toxicity is expected
  • Significant systemic anticoagulation occurs
  • Systemic adverse effects are minimal due to low absorption
  • It commonly causes systemic hyperglycemia

Correct Answer: Systemic adverse effects are minimal due to low absorption

Q16. The oral bioavailability of cromolyn sodium is:

  • High — nearly complete absorption
  • Moderate — about 50% absorbed
  • Low — poorly absorbed from the gastrointestinal tract
  • Variable — requires co-administration with enzymes

Correct Answer: Low — poorly absorbed from the gastrointestinal tract

Q17. Which of the following is a recognized benefit of cromolyn sodium in allergic airway disease?

  • Rapid bronchodilation in acute asthma exacerbations
  • Prophylactic reduction in mast cell mediator release and prevention of symptoms
  • Significant systemic immunosuppression
  • Permanent cure of asthma after single course

Correct Answer: Prophylactic reduction in mast cell mediator release and prevention of symptoms

Q18. Which monitoring parameter is most useful to assess response to cromolyn therapy in asthma?

  • Serum cromolyn concentration
  • Pulmonary function tests and symptom control
  • Daily liver enzyme panels
  • Complete blood count every 6 hours

Correct Answer: Pulmonary function tests and symptom control

Q19. Cromolyn sodium may inhibit release of mediators from which other inflammatory cell type besides mast cells?

  • Erythrocytes
  • Platelets only
  • Eosinophils (reducing eosinophil mediator release/migration)
  • Neurons exclusively

Correct Answer: Eosinophils (reducing eosinophil mediator release/migration)

Q20. For intranasal use in allergic rhinitis, cromolyn sodium is most effective when:

  • Used intermittently only after symptoms become severe
  • Used prophylactically or at allergen exposure to prevent symptoms
  • Administered as a single weekly dose
  • Combined with systemic antibiotics for best effect

Correct Answer: Used prophylactically or at allergen exposure to prevent symptoms

Q21. Which is the most appropriate patient counseling point for inhaled cromolyn sodium?

  • It provides immediate relief for acute breathlessness
  • It should be used regularly or before triggers for preventive benefit
  • It must be taken with grapefruit juice to enhance absorption
  • It causes strong sedation and should be taken at night

Correct Answer: It should be used regularly or before triggers for preventive benefit

Q22. Which statement about cromolyn sodium and pregnancy is most accurate?

  • It is absolutely contraindicated in pregnancy
  • It is generally considered safe and may be used when clinically indicated
  • It causes major fetal malformations and must be avoided
  • It is only used topically in pregnancy with mandatory fetal monitoring

Correct Answer: It is generally considered safe and may be used when clinically indicated

Q23. Which of the following best explains why cromolyn is dosed multiple times per day?

  • It has a very long half-life requiring frequent loading
  • It provides short-duration prophylactic effect and requires repeated dosing
  • It accumulates slowly and requires frequent dosing to prevent toxicity
  • It is rapidly converted to active metabolites necessitating frequent dosing

Correct Answer: It provides short-duration prophylactic effect and requires repeated dosing

Q24. Which patient is least likely to benefit from cromolyn therapy?

  • A patient with allergic rhinitis used intranasal prophylactically
  • A patient requiring immediate bronchodilation during status asthmaticus
  • A child with exercise-induced bronchospasm using pre-exercise dose
  • A patient with allergic conjunctivitis using ophthalmic drops

Correct Answer: A patient requiring immediate bronchodilation during status asthmaticus

Q25. Which pharmacological property explains low systemic adverse effects with inhaled cromolyn?

  • High oral bioavailability
  • Extensive hepatic activation producing toxic metabolites
  • Poor systemic absorption and local airway action
  • Strong inhibition of renal clearance enzymes

Correct Answer: Poor systemic absorption and local airway action

Q26. Cromolyn sodium’s mechanism helps prevent which phase of allergic response?

  • The immediate phase by preventing mast cell degranulation
  • The fever response mediated by pyrogens only
  • Autoimmune antibody production exclusively
  • Chronic infection by direct antibacterial action

Correct Answer: The immediate phase by preventing mast cell degranulation

Q27. In the context of inhalation therapy, an important pharmaceutical consideration for cromolyn sodium is:

  • It must be heated before nebulization
  • Particle size and delivery technique affect airway deposition and efficacy
  • It is effective only when given intravenously
  • It cannot be formulated as an aqueous solution

Correct Answer: Particle size and delivery technique affect airway deposition and efficacy

Q28. Which laboratory abnormality is commonly caused by cromolyn sodium?

  • Marked leukopenia
  • Elevated transaminases in most patients
  • No consistent or common laboratory abnormality — monitoring guided by clinical response
  • Severe hyponatremia

Correct Answer: No consistent or common laboratory abnormality — monitoring guided by clinical response

Q29. For patients using inhaled cromolyn, which concurrent therapy is essential to manage acute bronchospasm?

  • Short-acting beta-2 agonist (rescue inhaler) for acute relief
  • Stop all other asthma medications while using cromolyn
  • Only cromolyn is needed for both acute and chronic management
  • Oral antibiotics as rescue therapy

Correct Answer: Short-acting beta-2 agonist (rescue inhaler) for acute relief

Q30. Which statement best summarizes the clinical role of cromolyn sodium?

  • It is the first-line rescue medication for severe acute asthma
  • It is used prophylactically to prevent allergic mediator release and control symptoms in selected patients
  • It functions primarily as a systemic immunosuppressant
  • It is primarily an antibiotic used in respiratory infections

Correct Answer: It is used prophylactically to prevent allergic mediator release and control symptoms in selected patients

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