Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Triamcinolone”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed2005

Effect of intravitreal triamcinolone acetonide on susceptibility to experimental bacterial endophthalmitis and subsequent response to treatment.

OBJECTIVES: Recent reports of high endophthalmitis rates after intravitreal triamcinolone acetonide injection have raised concerns about the safety of this treatment. We sought to evaluate the effect of intravitreal triamcinolone injection on (1) the susceptibility to experimental bacterial endophthalmitis and (2) the subsequent therapeutic response to antibiotic treatment. DESIGN: For the susceptibility study, the right eye of 40 New Zealand white rabbits received an intravitreal injection of a known quantity of Staphylococcus epidermidis organisms. Half of the eyes received a simultaneous intravitreal injection of triamcinolone acetonide, 4 mg. All eyes were examined daily for signs of endophthalmitis (photophobia, conjunctival injection, and vitritis) using standardized grading protocols (scaled from 0 to 4 with increasing severity). On day 7, vitreous cultures were obtained. For the therapeutic response study, the right eye of 12 rabbits received an intravitreal injection of S epidermidis organisms sensitive to vancomycin. Half of the eyes received a simultaneous intravitreal injection of triamcinolone acetonide, 4 mg. All 12 eyes received an intravitreal injection of vancomycin hydrochloride, 1 mg, on development of the first signs of endophthalmitis. All eyes were examined daily for 7 additional days. On day 7 after treatment, vitreous cultures were obtained. RESULTS: In the susceptibility study, all 40 eyes developed signs of endophthalmitis. In eyes that received intravitreal bacteria plus triamcinolone, 17 (85%) of the 20 vitreous cultures were positive, whereas only 6 (30%) were positive in the 20 eyes receiving bacteria alone (P = .001). The vitritis was significantly increased in the bacteria plus triamcinolone group compared with the bacteria-only group (17 of 20 vs 7 of 20 with 4+ vitritis, respectively; P = .003). In the therapeutic response study, all 12 eyes developed clinical signs of endophthalmitis within 48 hours. All vitreous samples obtained 7 days after intravitreal vancomycin injection were culture negative. However, the severity of vitritis at the time of vitreous sampling was less in the eyes receiving triamcinolone plus bacteria compared with eyes receiving bacteria alone (0 of 6 vs 5 of 6 with 4+ vitritis, respectively; P = .02). CONCLUSIONS: In eyes with experimentally induced bacterial endophthalmitis, the presence of intravitreal triamcinolone results in a higher culture-positive rate and a higher degree of inflammation, suggesting an impaired ocular immune response and greater susceptibility to infection. However, in eyes with experimentally induced bacterial endophthalmitis receiving early treatment with intravitreal antibiotics, triamcinolone appears to suppress the ocular inflammatory response without impairing the therapeutic effect. CLINICAL RELEVANCE: These data suggest that caution must be exercised when combining intravitreal triamcinolone injection with intraocular surgery.

Animals↗
PubMed2004

[Intravitreal triamcinolone acetonide for the treatment of intraocular edematous and neovascular diseases].

BACKGROUND: Within the last 2 years, intravitreal application of triamcinolone acetonide has exponentially increased as a treatment option for various intraocular neovascular and edematous proliferative disorders. METHODS AND RESULTS: The best response to intravitreal triamcinolone acetonide injection in terms of gain in visual acuity was obtained for eyes with intraretinal edematous diseases such as diffuse diabetic macular edema, branch retinal vein occlusion, central retinal vein occlusion, and pseudophakic cystoid macular edema. Visual acuity increased and degree of intraocular inflammation decreased in eyes with various types of noninfectious uveitis including sympathetic ophthalmia. Intravitreal triamcinolone may be useful as angiostatic therapy in eyes with iris neovascularization and proliferative ischemic retinopathies. Possibly, intravitreal triamcinolone may be helpful for exudative age-related macular degeneration, alone or in combination with photodynamic therapy. In eyes with chronic, therapy-resistant, ocular hypotony, intravitreal triamcinolone can induce an increase in intraocular pressure and may stabilize the eye. The complications of intravitreal triamcinolone therapy, such as secondary ocular hypertension in about 40% of the eyes injected, cataractogenesis, postoperative infectious and noninfectious endophthalmitis, and pseudo-endophthalmitis will be covered in another article. Intravitreal triamcinolone injection can be combined with other intraocular surgeries including cataract surgery. Cataract surgery performed some months after the injection did not show a markedly elevated rate of complications. If vision increases after the intravitreal triamcinolone injection, the injection can be repeated. The duration of the effect of a single intravitreal injection of triamcinolone ranges between 2 and 9 months, probably depending on the dosage used. CONCLUSIONS: Intravitreal triamcinolone acetonide may offer a possibility for adjunctive treatment of intraocular oedematous and neovascular disorders. One has to take into account the side effects and the lack of long-term follow-up observations.

Aged↗
PubMed2005

Intravitreal triamcinolone acetonide for treatment of intraocular proliferative, exudative, and neovascular diseases.

Within the last three years, triamcinolone acetonide has increasingly been applied intravitreally as treatment option for various intraocular neovascular edematous and proliferative disorders. The best response in terms of gain in visual acuity after the intravitreal injection of triamcinolone acetonide was found in eyes with intraretinal edematous diseases such as diffuse diabetic macular edema, branch retinal vein occlusion, central retinal vein occlusion, and pseudophakic cystoid macular edema. Visual acuity increased and degree of intraocular inflammation decreased in eyes with various types of non-infectious uveitis including acute or chronic sympathetic ophthalmia and Adamantiadis-Behcet's disease. Intravitreal triamcinolone may be useful as angiostatic therapy in eyes with iris neovascularization and proliferative ischemic retinopathies. Possibly, intravitreal triamcinolone may be helpful as adjunct therapy for exudative age-related macular degeneration, possibly in combination with photodynamic therapy. In eyes with chronic, therapy resistant, ocular hypotony, intravitreal triamcinolone can induce an increase in intraocular pressure and may stabilize the eye. The complications of intravitreal triamcinolone therapy include secondary ocular hypertension in about 40% of the eyes injected, cataractogenesis, postoperative infectious and non-infectious endophthalmitis, and pseudo-endophthalmitis. Intravitreal triamcinolone injection can be combined with other intraocular surgeries including cataract surgery. Cataract surgery performed some months after the injection does not show a markedly elevated rate of complications. If vision increases and eventually decreases again after an intravitreal triamcinolone acetonide injection, the injection can be repeated. The duration of the effect of a single intravitreal injection of triamcinolone depended on the dosage given. Given in a dosage of about 20mg to non-vitrectomized eyes, the duration of the effect and of the side-effects was 6-9 months. Intravitreal triamcinolone acetonide may offer a possibility for adjunctive treatment of intraocular edematous and neovascular disorders. One has to take into account the side-effects and the lack of long-term follow-up observations.

Exudates and Transudates↗
PubMed2003

[Treatment of oedematous, proliferative and neovascular diseases by intravitreal triamcinolone acetonide].

BACKGROUND: Recent studies have suggested that intravitreal triamcinolone acetonide may be a therapeutical possibility for treating of various intraocular neovascular, oedematous and proliferative diseases. METHODS AND RESULTS: Gain in visual acuity was relatively highest for eyes with intraretinal oedematous diseases such as diffuse diabetic macular oedema and various types of cystoid macular oedema due to reasons such as retinal venous occlusions and uveitis. Intravitreal triamcinolone may be useful as angiostatic therapy in eyes with iris neovascularisation and proliferative ischaemic retinopathies. Possibly, intravitreal triamcinolone may be helpful for exudative age-related macular degeneration. In eyes with chronic therapy resistant ocular hypotony, intravitreal triamcinolone can induce an increase in intraocular pressure. The role of intravitreal triamcinolone as adjunctive treatment of proliferative vitreoretinopathy has not been determined so far. Complications of intravitreal triamcinolone include secondary ocular hypertension in about 50 % of the eyes injected, with one per cent of the eyes necessitating antiglaucomatous filtrating surgery; a cataractogenic effect; and postoperative infectious endophthalmitis. Long-term studies of more than 3 years follow-up have been missing so far, so that there is no reliable information on long-term complications. The injection can be combined with cataract surgery. Cataract surgery performed some months after the injection did not show a markedly elevated rate of complications. If vision increases after the intravitreal triamcinolone injection, the injection can be repeated. The duration of the effect of a single intravitreal injection of triamcinolone ranges between 2 and 9 months. Triamcinolone acetonide was detected in the aqueous humour nine months after an intravitreal injection of 25 mg. CONCLUSIONS: Intravitreal triamcinolone acetonide may offer a possibility for adjunctive treatment of intraocular oedematous, neovascular and proliferative diseases.

Angiogenesis Inhibitors↗
PubMedDate not supplied

Difference in clearance of intravitreal triamcinolone acetonide between vitrectomized and nonvitrectomized eyes.

PURPOSE: To study the difference in clearance of intravitreal triamcinolone acetonide quantitatively between vitrectomized and nonvitrectomized eyes. METHODS: Eighty-four eyes of 42 rabbits were divided in 2 groups: 42 right eyes underwent standard pars plana vitrectomy (vitrectomized group), and 42 left eyes were not operated on (nonvitrectomized group). All eyes received intravitreal injections with 0.1 mL (0.3 mg) of triamcinolone acetonide. Every 12 eyes were obtained by killing 6 rabbits 1, 2, 4, 7, 12, 20, or 30 days after intravitreal injection. Each eye was enucleated and immediately frozen at -70 degrees C. The frozen vitreous was prepared for measuring the concentration of triamcinolone acetonide. Triamcinolone acetonide was quantified by high-performance liquid chromatography and ultraviolet absorbance detection. RESULTS: After 30 days, triamcinolone acetonide was detected only in 1 eye (0.22 microg/mL) in the vitrectomized group compared with 4 of 6 eyes (0.92 +/- 1.25 microg/mL) in the nonvitrectomized group. The coefficient of logarithmic regression was -0.12 in the vitrectomized group and -0.08 in the nonvitrectomized group. Triamcinolone acetonide decreased 1.5 times more rapidly in the vitrectomized group than in the nonvitrectomized group. The half-life of triamcinolone acetonide was 1.57 days in the vitrectomized group and 2.89 days in the nonvitrectomized group. CONCLUSION: Intravitreal triamcinolone acetonide decreases more rapidly in the vitrectomized eye than in the nonvitrectomized eye. Therefore, the faster clearance of intravitreal triamcinolone acetonide must be considered when planning intravitreal injection of triamcinolone acetonide in the vitrectomized eye.

Animals↗
PubMed2005

Lumbar radiculopathy: treatment with selective lumbar nerve blocks--comparison of effectiveness of triamcinolone and betamethasone injectable suspensions.

PURPOSE: To retrospectively determine if there is a difference in the effectiveness of triamcinolone acetonide injectable suspension versus betamethasone sodium phosphate and betamethasone acetate injectable suspension in the treatment of radiculopathy and low back pain with selective lumbar nerve blocks. MATERIALS AND METHODS: This retrospective study was approved by the institutional review board and was HIPAA compliant; informed consent was not required. Charts and self-reported pain score evaluations were retrospectively reviewed in 114 patients (56 men, 58 women; age range, 36-84 years; mean age, 60 years) treated for radiculopathy from 1997 to 2003 with 130 selective lumbar nerve blocks with triamcinolone or betamethasone. Perineural location was confirmed with fluoroscopic guidance. Forty-nine patients received a mixture of 1 mL of the triamcinolone, 40 mg/mL, and 1 mL of 0.5% bupivacaine hydrochloride. Eighty-one patients received a mixture of 1 mL of the betamethasone, 6 mg/mL, and 1 mL of 0.5% bupivacaine hydrochloride. Patients completed standardized pain evaluation sheets and compared their pain with baseline levels during 14 days after injection. Fisher exact test was used for data analysis. RESULTS: From day 0 to 1 after the procedure, there was no statistically significant difference in improvement in low back pain and lower extremity pain between groups. On day 3, 42% of triamcinolone recipients and 58% of betamethasone recipients demonstrated improvement in low back pain (P = .04, Fisher exact test), whereas 55% of triamcinolone recipients and 57% of betamethasone recipients had lower extremity pain improvement (P = .33). On day 7, 45% of triamcinolone recipients and 58% of betamethasone recipients had improvement in low back pain (P = .38), whereas 52% of triamcinolone recipients and 57% of betamethasone recipients had improvement in lower extremity pain (P = .69). On day 14, 42% of triamcinolone recipients and 53% of betamethasone recipients had improvement in low back pain (P = .26), whereas 49% of triamcinolone recipients and 55% of betamethasone recipients had improvement in lower extremity pain (P = .69). CONCLUSION: Selective nerve root blocks with betamethasone and triamcinolone reduced low back pain and lower extremity pain, although there was no significant difference in effectiveness between the two.

Adult↗
PubMed2006

Intravitreal triamcinolone acetonide: a change in a paradigm.

BACKGROUND: Based on experimental studies and clinical observations by Robert Machemer, Gholam Peyman and others, the vitreous cavity has increasingly been used as a reservoir of drugs for the direct treatment of intraocular diseases. METHODS AND RESULTS: The most widely injected drug so far has been triamcinolone acetonide for various intraocular neovascular and edematous diseases. Comparing the various diseases with respect to effect and side effects of the treatment, the best response in terms of gain in visual acuity has been achieved for intraretinal edematous diseases such as diffuse diabetic macular edema, branch retinal vein occlusion, central retinal vein occlusion, and pseudophakic cystoid macular edema. In eyes with various types of noninfectious uveitis including acute or chronic sympathetic ophthalmia and Adamantiadis-Behçet's disease, visual acuity increased and the degree of intraocular inflammation decreased. Some studies have suggested that intra- vitreal triamcinolone may be useful as an angiostatic agent in eyes with iris neovascularization and proliferative ischemic retinopathies. Intravitreal triamcinolone may possibly be helpful as adjunct therapy for exudative age-related macular degeneration, particularly in combination with photodynamic therapy. In eyes with chronic, therapy-resistant ocular hypotony, intravitreal triamcinolone can induce an increase in intraocular pressure and may stabilize the eye. The complications of intravitreal triamcinolone therapy include secondary ocular hypertension in about 40% of the eyes injected; medically uncontrollable high intraocular pressure leading to antiglaucomatous surgery in about 1-2% of the eyes; posterior subcapsular cataract and nuclear cataract leading to cataract surgery in about 15-20% in elderly patients within 1 year after injection; postoperative infectious endophthalmitis with a rate of about 1:1,000; noninfectious endophthalmitis, perhaps due to a reaction to the solvent agent, and pseudoendophthalmitis with triamcinolone acetonide crystals appearing in the anterior chamber. Intravitreal triamcinolone injection can be combined with other types of intraocular surgery including cataract surgery, particularly in eyes with iris neovascularization. Cataract surgery performed some months after the injection does not show a markedly elevated complication rate. The injection may be repeated, if vision redecreases. In nonvitrectomized eyes, the duration of the effect and side effects of a single intravitreal injection of triamcinolone is about 6-9 months for a dosage of about 20 mg, and about 2-4 months for a dosage of 4 mg. It has remained unclear so far, whether and how to remove the solvent agent. In the future, intravitreal triamcinolone may be combined with other antiangiogenic drugs for the treatment of exudative age-related macular degeneration or with neuroprotective drugs for treatment of diabetic retinopathy. CONCLUSIONS: Despite an exponentially increasing number of mostly case-series studies, the intravitreal injection of triamcinolone may still be considered an experimental procedure until randomized studies have been presented.

Animals↗
PubMed1994

Effect of triamcinolone on parathyroid hormone-stimulated second messenger systems and phosphate transport in opossum kidney cells.

Although PTH is known to stimulate both the adenylate cyclase/protein kinase-A system and the phospholipase-C/protein kinase-C second messenger systems, the relative roles of these second messenger pathways remain unclear. The present studies were designed to examine the effect of triamcinolone on PTH-stimulated second messenger systems and phosphate transport in confluent cultures of opossum kidney cells. Triamcinolone was added to these cultures at a concentration of 10 nM for 24-48 h. Neither cell number nor protein content was changed by this treatment. The addition of triamcinolone did not alter PTH receptor binding or competitive displacement radioligand binding assay curves. PTH-stimulated cAMP generation and activation of protein kinase-A were not altered by triamcinolone. The glucocorticoid, however, increased basal phosphate uptake from 1.0 +/- 0.1 to 1.28 +/- 0.1 pmol/5 min.culture (P < 0.01). Phosphate transport was significantly decreased by PTH (0.01 nM) in the triamcinolone-treated cultures, but not in control cultures. Phosphate uptake in the presence of maximal doses of PTH was similar in both control and triamcinolone-treated cultures. Thus, the PTH-responsive component of phosphate transport was preserved, and the threshold dose for the effect of PTH was reduced after treatment with triamcinolone. Studies were then performed to evaluate the alternate second messenger pathway. In control cultures, PTH rapidly increased the level of diglyceride mass, as measured by diglyceride kinase assay, from 0.18 +/- 0.01 to a peak of 0.26 +/- 0.02 mol/100 mol total phospholipid (P < 0.002), 1 min after addition of the hormone. Triamcinolone pretreatment for 48 h, however, elevated the basal diglyceride levels, but the increase after the addition of PTH was totally abolished. The absence of an increase in diglyceride upon stimulation with PTH correlated with elimination of the PTH-stimulated increase in the activity of particulate protein kinase-C. Thus, in triamcinolone-treated cells, the effect of PTH on phosphate transport was preserved, and the threshold dose of PTH-induced alteration in phosphate transport was reduced in the absence of stimulation of this alternate second messenger pathway. These data show that triamcinolone in opossum kidney cells does not alter PTH activation of the cAMP/protein kinase-A system, but eliminates the increase in diglyceride and the activation of protein kinase-C in response to PTH. These studies emphasize the major role of the protein kinase-A system in the regulation of phosphate transport by PTH.

1-Methyl-3-isobutylxanthine↗
PubMed1985

Triamcinolone acetonide regulates glucocorticoid-receptor levels by decreasing the half-life of the activated nuclear-receptor form.

Glucocorticoid-receptor activation in GH1 cells results from the conversion of a 10 S oligomeric cytosolic form to a 4-5 S nuclear-binding species (Raaka, B. M., and Samuels, H. H. (1983) J. Biol. Chem. 258, 417-425). In this study, we report that triamcinolone acetonide (9 alpha-fluoro-11 beta, 16 alpha, 17 alpha, 21-tetrahydroxypregna-1,4-diene-3,20-dione 16,17-acetonide) elicits a time- and dose-dependent reduction of total-cell (nuclear + cytoplasmic) receptor. The mechanism of receptor regulation was studied by dense amino acid labeling of receptor using media containing 2H, 13C, and 15N-labeled amino acids. Total cell receptor was extracted with 0.4 M KCl and newly synthesized dense receptor was separated from pre-existing receptor of normal density by centrifugation in gradients of 15-30% sucrose (w/v) in D2O. Receptor levels in cells grown without [3H]triamcinolone acetonide was 260 +/- 19 fmol/100 micrograms of DNA (16,000 molecules/cell), and, with 10 nM [3H]triamcinolone acetonide, this decreased to 130 +/- 14 fmol/100 micrograms of DNA after 30 h. Receptor half-life was 19 +/- 1.9 h in the absence and 9.5 +/- 0.3 h in the presence of triamcinolone acetonide and accounted for the decrease in steady-state receptor levels. Receptor synthesis was 9.7 +/- 0.3 fmol/100 micrograms of DNA/h (580 molecules/cell/h) both in the presence and absence of 10 nM [3H]triamcinolone acetonide. Triamcinolone acetonide reduced the half-life in proportion to the extent of receptor occupancy and activation. During the approach to steady-state conditions, 10 nM [3H]triamcinolone acetonide shortened receptor half-life almost immediately to the value in cells grown with [3H]triamcinolone acetonide for 24 h or longer. Cycloheximide did not prevent the triamcinolone acetonide-mediated decrease in receptor half-life and the shortening of receptor half-life is rapidly reversed by removal of hormone. These studies support a model of receptor regulation in which triamcinolone acetonide converts the unactivated 10 S receptor to the activated 4-5 S form which is degraded at an increased rate by the cell.

Animals↗
PubMed1995

Biochemical quantification of triamcinolone in subconjunctival depots.

OBJECTIVE: To biochemically quantify the amount of active triamcinolone acetonide remaining after subconjunctival administration and to assess the effectiveness of surgical management for glaucoma induced by triamcinolone. DESIGN: Case series. PARTICIPANTS: Seven eyes of seven patients whose ages ranged from 47 to 84 years underwent excision of depot triamcinolone. Six of seven eyes required surgical intervention for medically unresponsive intraocular pressure (IOP) elevation. RESULTS: Pharmacologically active triamcinolone was identified up to 13 months following injection (range, 3 to 13 months). The mean amount in the excised sample was 5.4 mg (range, 2.0 to 8.8 mg), and the mean percentage of the original sample remaining was 20% (range, 4.2% to 44%). Glaucoma was diagnosed a mean of 3 months after injection (range, 1 to 6 months). Mean IOP was 37 mm Hg before excision and 16 mm Hg after removal. Surgical excision of visible triamcinolone normalized IOP in six of seven patients without need for glaucoma medications. CONCLUSIONS: Periocular injection of triamcinolone necessitates careful monitoring of IOP. Medically unresponsive IOP elevation may occur as late as 6 months following periocular triamcinolone injection. Surgical excision of remaining triamcinolone depot is an effective therapy for IOP elevation. Guidelines for safely using triamcinolone are discussed.

Aged↗
PubMed1997

Fluticasone propionate powder administered through Diskhaler versus triamcinolone acetonide aerosol administered through metered-dose inhaler in patients with persistent asthma.

BACKGROUND: Attempts to delineate efficacy and safety differences among inhaled corticosteroids have been difficult because of the lack of well-controlled, comparative studies reported in the medical literature. METHODS: A randomized, double-blind, double-dummy study was conducted in 24 outpatient centers. A total of 291 male and female patients at least 12 years of age with asthma (FEV1 between 50% and 80% of predicted value), who had previously received maintenance therapy with beclomethasone dipropionate or triamcinolone acetonide, were switched to treatment with fluticasone propionate powder (250 microg twice daily), triamcinolone acetonide aerosol (200 microg four times daily), or placebo for 24 weeks. RESULTS: Mean increase in FEV1 from baseline to end point was significantly (p = 0.009) greater in patients switched to treatment with fluticasone compared with patients switched to treatment with triamcinolone (0.27 L and 0.07 L, respectively). At end point, mean increase in morning peak expiratory flow from baseline was 21 L/min with fluticasone compared with mean decreases of 6 L/min and 28 L/min with triamcinolone and placebo, respectively (p < 0.001 vs triamcinolone and placebo). Supplemental rescue albuterol use decreased by 30% from baseline with fluticasone (p < 0.05 vs triamcinolone and placebo) compared with triamcinolone (6%) or placebo (increased by 50%). The percentage of patients withdrawn from the study because they met predefined lack-of-efficacy criteria was higher with placebo (60%) and triamcinolone (27%) than with fluticasone (17%). Incidence of adverse events and low morning plasma cortisol concentrations were similar across treatment groups except for oral candidiasis (p = 0.035, fluticasone vs placebo). CONCLUSION: Fluticasone propionate powder twice daily (500 microg/day) was superior in efficacy to triamcinolone acetonide aerosol four times daily (800 microg/day) in patients with persistent asthma.

Administration, Inhalation↗
PubMed2006

Short-term effect of intracameral triamcinolone acetonide on corneal endothelium using the rabbit model.

PURPOSE: To investigate the effect of intracameral injection of triamcinolone acetonide on the corneal endothelium in rabbit eyes. METHODS: Triamcinolone acetonide (40 mg/ml, 0.2 cm3) after filtering and resuspension in balanced salt solution (BSS) was injected intracamerally for 3 min into 10 rabbit eyes and irrigated with 5 cm(3) of BSS. Triamcinolone without resuspension and BSS were injected, respectively, into five rabbit eyes. Endothelial toxicity was evaluated and compared by measurements of endothelial cell counts and central corneal thickness. The endothelial viability was determined using vital staining with alizarin red and trypan blue at 2 h after injection. The scanning electron microscopy (SEM) was performed in one cornea from each group. RESULTS: Endothelial cell counts and central corneal thickness following intracameral injection of triamcinolone acetonide did not significantly change when compared to controls. The mean percentage of viable endothelial cells was 99.50, 99.52, and 99.49% in the resuspended triamcinolone group, triamcinolone without resuspension group, and BSS group, respectively (P=0.46, Kruskall-Wallis test). But SEM showed reduced microvilli of endothelial surface in an eye of the triamcinolone without resuspension group. CONCLUSIONS: The intracameral injection of triamcinolone acetonide did not induce a significant visible change of endothelium in rabbit eyes. However, ultrastructural villi changes observed suggest a possibility of microstructural damages in endothelium with triamcinolone acetonide injection when used without filtering and resuspension.

Animals↗
PubMedDate not supplied

Protective effect of antiinflammatory corticosteroid triamcinolone in cisplatin nephrotoxicity.

The corticosteroid, triamcinolone, was examined as a potential antagonist for the nephrotoxicity of cisplatin in female Wistar rats. The changes in renal function and renal morphology were assessed on the 3rd day after administration of cisplatin (7.5 mg/kg BW) and in animals given triamcinolone retard (4 mg/kg BW) 6 h before administration of cisplatin. Pretreatment with triamcinolone resulted in much less severe changes in renal function after cisplatin administration (serum urea: triamcinolone plus cisplatin 14.29 +/- 1.90 mg/l, cisplatin alone 21.60 +/- 2.34 mg/l, p < 0.05, control 2.78 +/- 0.19 mg/l, serum creatinine: triamcinolone plus cisplatin 0.21 +/- 0.02 mg/l, cisplatin alone 0.30 +/- 0.02 mg/l, p < 0.05, control 0.06 +/- 0.01 mg/l). In contrast to cisplatin-treated animals in triamcinolone-pretreated rats alterations of water content were found neither in renal cortex (triamcinolone plus cisplatin 3.39 +/- 0.16 g/g dry weight, cisplatin alone 4.07 +/- 0.07 g/g dry weight, control 3.07 +/- 0.07 g/g dry weight) nor in outer medulla (triamcinolone plus cisplatin 4.20 +/- 0.22 g/g dry weight, cisplatin alone 4.98 +/- 0.21 g/g dry weight, control 3.84 +/- 0.11 g/g dry weight) compared to control. The structure of the kidney following cisplatin administration demonstrated extensive lesions of S3 segments of the proximal tubule. The changes in proximal convoluted tubules were widespread and ranged from the decrease of the amount of microvilli to loss of brush border or even to cell death. In triamcinolone-pretreated rats the structure of the cortex appeared to be virtually normal and tissue of medulla was only slightly damaged.

Animals↗
PubMed1999

A pharmacokinetic study to evaluate the absolute bioavailability of triamcinolone acetonide following inhalation administration.

Triamcinolone acetonide is a glucocorticoid administered by oral inhalation in the management of asthma. With oral inhalation of glucocorticoids, systemic absorption can come from oropharyngeal, gastrointestinal, or airway deposition of the drug. The objectives of this study were to determine the absolute bioavailability of triamcinolone acetonide following inhalation administration and to delineate the airway contribution of triamcinolone acetonide absorption relative to the absolute bioavailability. All subjects received a 5-minute 400 mcg intravenous infusion of triamcinolone acetonide and a single 800 mcg dose of inhaled triamcinolone acetonide with and without oral charcoal administration in a randomized three-way crossover fashion. The oral charcoal allowed for isolating the pulmonary component of absorption by adsorbing the oropharyngeal and gastrointestinal deposited drug. The mean (+/- SD) absolute bioavailability value for inhaled triamcinolone acetonide was 25% (8.75%). Delineation of the airway contribution of triamcinolone acetonide absorption showed that 10.4% of an inhaled dose is absorbed as triamcinolone acetonide from the lungs. Mean (+/- SD) total body clearance was rapid at 0.57 (0.12) L/hr/kg. The mean (+/- SD) apparent volume of distribution following the intravenous dose was a low 1.96 (0.31) L/kg. No significant differences were noted in the apparent terminal elimination half-life of triamcinolone acetonide (approximately 2.4 hr) between treatments.

Administration, Inhalation↗
PubMedDate not supplied

Cataract surgery combined with intravitreal injection of triamcinolone acetonide.

PURPOSE: To evaluate whether the addition of cataract surgery to an intravitreal injection of triamcinolone acetonide markedly increases frequency and spectrum of complications. METHODS: The comparative nonrandomized clinical interventional investigation included a study group of 60 eyes (56 patients) undergoing cataract surgery and additionally receiving an intravitreal injection of about 20 mg of triamcinolone acetonide and a triamcinolone control group of 290 eyes (262 patients) that consecutively received an intravitreal injection of about 20 mg triamcinolone acetonide without cataract surgery. Reasons for intravitreal injection of triamcinolone acetonide were exudative age-related macular degeneration (n=228; 65%), diffuse diabetic macular edema (n=94; 27%), central retinal vein occlusion (n=17; 5%), and branch retinal vein occlusion (n=11; 3%). Mean follow-up was 8.6+/-6.8 months. A second control group included 1068 patients (1068 eyes) who consecutively underwent routine cataract surgery without intravitreal injection. RESULTS: Study group and triamcinolone control group did not vary significantly in best visual acuity during follow-up (p=0.08), final visual acuity at the end of follow-up (p=0.30), maximal intraocular pressure during follow-up (p=0.99), frequency of an intraocular pressure higher than 21 mmHg (p=0.66), and intraocular pressure at the end of follow-up (p=0.06). Postoperative infectious endophthalmitis, wound leakage or other corneal wound healing problems, persisting corneal endothelial decompensation, rhegmatogenous retinal detachment, marked postoperative pain, or a clinically significant decentration of the intraocular lens were not observed. Study group and the non-triamcinolone control group did not vary significantly in the rate of posterior lens capsule rupture (p=0.11), postoperative infectious endophthalmitis, and persisting postoperative corneal endothelial decompensation. CONCLUSIONS: The addition of cataract surgery to an intravitreal injection of triamcinolone acetonide may not markedly increase amount and frequency of side effects and complications of intravitreal triamcinolone acetonide. No safe conclusions can be reached regarding differences in frequency of postoperative infectious endophthalmitis.

Aged↗
PubMed2002

[Effect of triamcinolone acetonide, montelukast, nedocromil sodium and formoterol on eosinophil blood counts, ECP serum levels and clinical progression of asthma in children].

Eosinophil-mediated damage to the respiratory epithelium is a major pathogenetic mechanism in asthma. Glucocorticoids have confirmed antiinflammatory properties and effect of formoterol, montelukast and nedocromil on markers of inflammation has been studied. Eosinophil blood counts and eosinophil cation protein (ECP) serum level are often use as markers of clinical monitoring of the disease activity. To evaluate the effect of treatment on allergic inflammation, we measured eosinophil blood counts and ECP serum level, and clinical parameters before and after 4 weeks treatment with triamcinolon, montelukast, nedocromil, formoterol. It was 8 week, placebo-controlled and randomized, double blind trial of 154 children with moderate atopic asthma. Patients were randomly allocated to receive 400 mg triamcinolon (n = 28), 5 or 10 mg (according to age) montelukast (n = 27), 16 mg nedocromil (n = 26), 24 micrograms formoterol (n = 28) or placebo (n = 45). 140 children completed the study. After treatment with triamcinolon and montelukast eosinophil blood counts significantly decreased, after treatment with triamcinolon, montelukast and nedocromil ECP serum level significantly decreased; all clinical parameters improved after treatment with each drug; treatment with triamcinolon had the strongest effect on most parameters (except of FEV1). Mean eosinophil blood counts before and after treatment with triamcinolon were 277.4 and 187.2 cells/mm3 respectively (p < 0.001); with montelukast were 279.6 and 250.7 cells/mm3 respectively (p = 0.002); with nedocromil were 181.7 and 170.1 cells/mm3 respectively (p < 0.183); with formoterol were 276.4 and 264.1 cells/mm3 respectively (p = 0.2). Mean ECP serum levels before and after treatment with triamcinolon were 94.3 and 63.5 micrograms/l respectively (p < 0.001); with montelukast were 85.1 micrograms/l and 71.2 micrograms/l respectively (p < 0.001); with nedocromil were 92.6 and 80.1 micrograms/l respectively (p < 0.001); with formoterol were 95.9 micrograms/l and 87.8 micrograms/l (p = 0.05). We found significant correlation between ECP and hyperresponsiveness after treatment with triamcinolon, montelukast. This study shows that triamcinolon, montelukast contribute to inhibition of allergic inflammation by decreasing eosinophil blood counts and ECP. The serum level of ECP seems to be a good clinical marker of monitoring the disease.

Acetates↗
PubMed2005

Electroretinographic effects of an intravitreal injection of triamcinolone in rabbit retina.

OBJECTIVE: To investigate the clinical, histologic, and electroretinographic effects of intravitreal injection of triamcinolone acetonide suspension in the rabbit retina. METHODS: Three groups of 6 rabbits each received intravitreal injections. Group 1 received 4 mg of triamcinolone acetonide, group 2 received an equal volume (0.1 mL) of the corticosteroid supernatant, and group 3 received 4 mg of triamcinolone acetonide with the supernatant replaced with balanced salt solution. Uninjected left eyes served as controls. Electroretinograms were obtained at baseline and at 3 to 4 and 6 to 7 days after injection of triamcinolone. Enucleated eyes were examined histologically. RESULTS: Ocular examination revealed no differences among the 3 groups. When subjected to stimulation with moderate to high flash intensities, eyes that had received intravitreal injections of triamcinolone (groups 1 and 3) had a 10% to 25% increase in dark-adapted a- and b-wave electroretinographic amplitudes. No histologic differences were observed between injected and control eyes. CONCLUSIONS: Intravitreal injection of 4 mg of triamcinolone acetonide does not cause a toxic reaction in the rabbit retina after 7 days. Triamcinolone therapy may augment the rod-driven electroretinographic responses, suggesting a mechanism by which visual function may improve. Clinical Relevance Evaluation of the toxic effects of triamcinolone is useful because of increased applications of intravitreal injection.

Animals↗
PubMed1997

Adrenal suppression with high doses of inhaled fluticasone propionate and triamcinolone acetonide in healthy volunteers.

STUDY OBJECTIVE: This study was conducted to compare the adrenal suppression of inhaled fluticasone propionate and triamcinolone acetonide in healthy volunteers, both given via their respective pressurised metered dose inhaler (pMDI) devices at high doses within the manufacturers recommended dose range. DESIGN: We used a single (investigator) blind, randomised, crossover design comparing a total daily dose of 1.625 mg fluticasone propionate delivered via a pMDI, 1.60 mg daily of triamcinolone acetonide delivered via a pMDI with integrated spacer, or placebo pMDI; each drug was given in two divided doses at 0800 hours and 2200 hours over a 24-h period. Each drug treatment was separated by a 1-week washout. PATIENTS: Twelve normal subjects mean age 27.5 years were studied. MEASUREMENTS: Blood samples were taken for 0800 hours plasma cortisol, i.e. 10 h following the second dose. Ten hour urine collections (2200 hours until 0800 hours) were taken for urinary cortisol and creatinine excretion. RESULTS: For the 0800 hours plasma cortisol (geometric mean, nmol.1(-1) compared with placebo (353) fluticasone propionate (138) produced significant (P < 0.05) suppression (2.57-fold difference), whereas triamcinolone acetonide (263) did not (1.34-fold difference). Fluticasone propionate produced a 1.91-fold greater adrenal suppression than triamcinolone acetonide (95% CI 1.10 to 3.33). Individual subjects with abnormally low 0800 hours cortisol values < 150 nmol.1(-1) (< 5.4 micrograms/dl) were n = 4 for fluticasone propionate and n = 0 for triamcinolone acetonide. Overnight urinary cortisol/creatinine ratio (geometric mean, nmol/mmol) did not show any difference between fluticasone propionate (1.48) and triamcinolone acetonide (1.60), with both producing significant suppression versus placebo (4.01): triamcinolone acetonide 2.50-fold difference (95% CI 1.45-4.24); fluticasone propionate 2.71-fold difference (95% CI 1.57-4.69). CONCLUSION: Fluticasone propionate 1.625 mg/day (pMDI) produced an approximately two-fold greater adrenal suppression of 0800 hours plasma cortisol than triamcinolone acetonide 1.60 mg per day (Oral Inhaler) when given twice daily, and one third of subjects with fluticasone had abnormally low 0800 hours cortisol values < 150 nmol.1(-1) (< 5.4 micrograms.dl-1. There were no differences between the drugs for urinary cortisol excretion. Further dose-ranging studies are required at steady-state in asthmatic subjects in order to see whether differences occur at lower doses on the steep part of the dose-response curve for both plasma and urinary cortisol suppression.

Administration, Inhalation↗