What is Triamcinolone?
Triamcinolone is used as an alternative treatment for adrenal insufficiency. It is also used in the symptomatic treatment of inflammatory and allergic disorders and to suppress the immune system. Triamcinolone is also effective in congenital adrenal hyperplasia of cerebral edema and rheumatic diseases.
Mechanism of action of Triamcinolone
The drug binds to its receptors in the cytoplasm by passing through the cell membrane, and the drug-receptor complex enters the cell nucleus. By binding to specific regions of DNA, this complex stimulates the mRNA transcription process, followed by the production of enzymes that are ultimately responsible for the systemic effects of corticosteroids. Corticosteroids exert their anti-inflammatory effects by preventing the accumulation of inflammatory cells in the area of inflammation, inhibiting phagocytosis and the release of enzymes responsible for inflammation, and inhibiting the production and release of chemical mediators of inflammation.
Pharmacokinetics of Triamcinolone
The injectable form of triamcinolone is well absorbed from muscle. The half-life of the drug is about 2-3 hours. It is converted to inactive metabolites mainly in the liver and to some extent in the kidneys and tissues. Due to the presence of flora in the structure of triamcinolone, its metabolism is slow. Inactive metabolites of this drug are excreted by the kidneys.
Contraindications to the use of Triamcinolone
It is contraindicated in the prevention of neonatal respiratory distress syndrome in the presence of amniotic fluid, infection or fever, herpes type 2 infection, placental insufficiency or premature rupture of the membrane.
Side effects of Triamcinolone
Hematology and Oncology: Bruising
Nervous, muscular and skeletal: arthritis
Respiratory: cough, sinusitis
Other complications (percentage unknown):
Cardiovascular: bradycardia, cardiac arrhythmia, heart failure, enlargement of the heart, cerebrovascular events, shock, edema, embolism (fat), hypertension, hypertrophic cardiomyopathy (premature infants), myocardial rupture (following recent myocardial infarction), syncope Tachycardia, thromboembolism, thrombophlebitis, vasculitis
Skin: Acne vulgaris, allergic dermatitis, atrophic striae, increased sweating, bruising, thinning of the epidermis, redness of the skin, flaking of the skin, hyperpigmentation (hyperthermia), hypopigmentation, unintended suppression of the skin test reaction, atrophy Subcutaneous atrophy, thinning hair, urticaria, dry skin
Endocrinology and metabolism: Calcinosis, Decreased glucose tolerance, Decreased serum potassium, Diabetes mellitus, Drug-induced Cushing syndrome, Water retention, Urinary glucose, Growth retardation, Hirsutism, Impaired glucose tolerance / Prediabetes, Resistance to Insulin, Menstrual disorders, Moon-shaped face, Negative nitrogen balance, Change in body fat mass distribution (BFR), Secondary adrenal cortex insufficiency, Sodium retention, Weight gain
Gastrointestinal: bloating, change in bowel habits, gastrointestinal bleeding, gastrointestinal perforation, hiccups, increased appetite, nausea, pancreatitis, peptic ulcer, esophageal ulcer
Genitourinary: bladder dysfunction, postmenopausal bleeding, sperm disorders
Hematology and oncology: non-thrombocytopenic purpura, petechiae
Liver: Enlargement of the liver, increased liver enzymes
Hypersensitivity: Anaphylaxis, angioedema
Infectious: Increased risk of infection, infection, non-infectious abscess
Topical: recurrence after injection
Central nervous system: abnormal sensory symptoms, arachnoid inflammation, depression, unstable emotions, euphoria, headache, idiopathic intracranial hypertension (after discontinuation), increased intracranial pressure, insomnia, boredom, meningitis, mood swings, Muscle weakness, neuritis, neuropathy, leg paralysis, limb drowsiness, personality disorder, mental disorders, quadriplegia, seizures, spinal cord injury, dizziness
Neuromuscular and musculoskeletal: amyotrophic, aseptic necrosis of the femoral head, aseptic necrosis of the humerus, bone fracture, Charcot’s arthropathy, lupus erythematosus-like rash, osteoporosis, tendon rupture, steroid myopathy, compression fracture
Ocular: Blindness (pericular; rare), cataracts, cortical blindness, exophthalmos, glaucoma, increased intraocular pressure, swelling of the visual disc
Renal: Increased urinary calcium excretion
Pulmonary: Pulmonary edema
Miscellaneous: Impairment of wound healing
Category X Interactions (Avoidance)
Aldesloquine, BCG (Intravesical), Cladribine, Desmopressin, Foxinidazole, Indium 111 Caprombe Pendedide, Loxapine, Massimurlin, Mifamortide, Mifepristone, Natalizumbe, Pimcrolimus (Tacitolimus)
Reduction of the effects of drugs by Triamcinolone (systemic)
Aldesloquine, Antidiabetic Drugs, Acycabetagen Silolocell, BCG (Intravesical), Calcitriol (Systemic), Coccidioid Imit Dermal Test, Corticorlin, Cosintropin, Hyaluronidase, Indium 111 Capromus Pendemide, Neumide Salicylates, Cipolocell T, Somatropin, Tacrolimus (systemic), Tertomotide, Tizagencellocell, Drugs for treatment of urea cycle disorders, Vaccine (live), Vaccine (inactive)
Reducing the effects of Triamcinolone (systemic) by drugs
Strong inducers of CYP3A4, Echinacea, Mifepristone, Mitotane, Tobacco
Increased effects of drugs by Triamcinolone (systemic)
Acetylcholinesterase inhibitors, Amphotericin B, Androgens, Baristinib, Defrasirox, Desirodine, Desmopressin, Faxinidazole, Fingolimod, Leflunamide, Loop diuretics, Non-selective drugs, Loxapine, Natalizum, Anti-eloride Quinolones, Ritodrine, Sargramostim, Siponimod, Thiazides and thiazide-like diuretics, Tofacitinib, Opadacitinib, Vaccine (live), Vitamin K antagonists
Increased effects of triamcinolone (systemic) by drugs
Combined products of hepatitis C virus, aperpitant, cladribine, potent inhibitors of CYP3A4, denosumbe, diltiazem, estrogen derivatives, fosperpitant, indacatrol, robelizombe, mifepristone, neuromuscular inhibitors, o-musculoskeletal neoplasm , Tacrolimus (topical), trastuzumab
has not been stated.
1. The dosage of the drug should be determined exactly by the doctor.
2. Long-term use of the drug in children can lead to growth retardation.
3. It is not recommended during breastfeeding due to its intake into milk, especially when consuming large amounts.
4. Following the use of this drug, hypothalamic-pituitary-adrenal function tests may be impaired.
5. The amount of medication used in children should be determined on the basis of milligrams of medication per child’s body surface area.
6. Larger amounts of triamcinolone are more likely to cause proximal occlusion, so it is best to avoid chronic treatments with these drugs.
Triamcinolone Medication Recommendations
1. Avoid abrupt discontinuation of the drug after prolonged use (more than 3 weeks).
2. During treatment, sodium intake should be limited and potassium supplements are recommended.
3. Ophthalmological examinations should be performed regularly during long-term treatment.
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