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PubMed2004

Serum levels of triamcinolone acetonide after intravitreal injection.

PURPOSE: To evaluate serum levels of triamcinolone acetonide after intravitreal high-dose injection. DESIGN: Prospective, interventional case series study. METHODS: For 20 consecutive patients, venous blood samples were taken before and 13 +/- 19 days (range 4 to 92) after an intravitreal injection of 20 to 25 mg triamcinolone acetonide as treatment of edematous macular diseases. RESULTS: Serum levels of triamcinolone acetonide did not differ significantly (P =.174; t test for paired matches) preoperatively (0 microg/l) and postoperatively (0.065 microg/l +/- 0.21 microg/l). In 18 eyes (90%), triamcinolone acetonide could not be detected in serum samples. For two patients (10%), serum samples taken 5 days and 7 days after the injection, respectively, contained 0.5 microg/l triamcinolone acetonide and 0.8 microg/l triamcinolone acetonide, respectively. CONCLUSION: After an intravitreal high-dose injection of 20 to 25 mg triamcinolone acetonide, triamcinolone acetonide is not, or only marginally, detectable in serum samples obtained within 4 to 92 days after the injection.

Adult↗
PubMed2005

Triamcinolone acetonide concentration after filtration of the solvent agent.

PURPOSE: To determine the amount of triamcinolone acetonide and the preservative benzyl alcohol after filtration. DESIGN: Laboratory investigation. METHODS: The probes were prepared by two different hospital pharmacies. The probes of the first pharmacy included 20 probes with 25-mg triamcinolone acetonide, unfiltered (n = 5 probes) or filtered (n = 5), or with 4-mg triamcinolone acetonide, filtered (n = 5) or unfiltered (n = 5). The probes for the second pharmacy were filtered (n = 3) probes of 25-mg triamcinolone acetonide. RESULTS: For the probes of the first pharmacy, triamcinolone acetonide dosages were 2.4 +/- 0.8 mg, 3.1 +/- 0.6 mg, 12.8 +/- 0.7 mg, and 23.4 +/- 2.3 mg, respectively, for the filtered 4-mg probes, unfiltered 4-mg probes, filtered 25-mg probes, and unfiltered 25-mg probes, respectively. For the second pharmacy, mean triamcinolone acetonide dosage was 23.8 +/- 0.6 mg for the 25-mg filtered probes and contained benzyl alcohol in a mean concentration of 0.0013 +/- 0.0001 mg/0.1 ml. CONCLUSIONS: Depending on the method employed and the pharmacy, preparation of triamcinolone acetonide including filtration of the solvent agent leads to a marked inter-pharmacy variation and a relatively low intra-pharmacy variation in the reduction of triamcinolone acetonide dosage.

Benzyl Alcohol↗
PubMed2006

Intraoperative intraocular triamcinolone injection prophylaxis for post-cataract surgery fibrin formation in uveitis associated with juvenile idiopathic arthritis.

PURPOSE: To assess the efficacy of a single intraoperative intraocular injection of triamcinolone acetonide during cataract surgery to prevent postoperative fibrin formation in patients with iridocyclitis associated with juvenile idiopathic arthritis. SETTING: Department of Ophthalmology, St. Franziskus Hospital, Muenster, Germany. METHODS: The charts of 22 patients (16 girls and 6 boys) with juvenile idiopathic arthritis and chronic iridocyclitis having lensectomy and anterior vitrectomy were retrospectively reviewed. In 12 patients (14 eyes), triamcinolone acetonide 4 mg was injected into the anterior chamber at the end of the surgery (triamcinolone group). Another 10 patients (13 eyes) received an intraoperative intravenous injection of methylprednisolone and postoperative oral prednisolone (systemic treatment group). No intraocular lenses were implanted. Postoperatively, prednisolone acetate 1% eyedrops were given. The main problems included intraocular inflammation, the need for additional systemic corticosteroids, and intraocular pressure (IOP) elevation. RESULTS: The mean patient age was 10.6 years +/- 3.1 (SD) in the triamcinolone group and 7.4 +/- 2.7 years in the systemic treatment group. The mean follow-up was 9.9 +/- 3.6 months and 10.9 +/- 1.2 months, respectively. All patients were taking systemic immunosuppression before surgery, and the medication was continued postoperatively. Fibrin formation was not seen after surgery in the triamcinolone group but occurred in 5 patients in the systemic treatment group (P = .02). Additional systemic corticosteroids were not required in the triamcinolone group. All patients had visual acuity improvement. No increase in IOP was noted after the triamcinolone acetate injections. CONCLUSIONS: Intraoperative intraocular injection of 4 mg of triamcinolone acetonide may be more effective than intraoperative intravenous methylprednisolone and additional postoperative short-term oral prednisolone in preventing postoperative fibrin formation after cataract surgery in patients with juvenile idiopathic arthritis and iridocyclitis.

Anterior Chamber↗
PubMed2005

Intraocular pressure elevation after intravitreal triamcinolone acetonide injection.

PURPOSE: To report on intraocular pressure (IOP) after intravitreal injections of triamcinolone acetonide. DESIGN: Meta-analysis of previously reported data and case series studies. PARTICIPANTS: The study included 272 patients (305 eyes) receiving an intravitreal injection of approximately 20 mg triamcinolone acetonide as treatment for diffuse diabetic macular edema (n = 84 patients), exudative age-related macular degeneration (n = 181 patients), retinal vein occlusions (n = 20 patients), uveitis (n = 9), pseudophakic cystoid macular edema (n = 6), and other reasons (n = 5). Mean follow-up was 10.4+/-6.7 months (median, 7.9 months; range, 3.0-35.7 months). INTERVENTION: Intravitreal injection of approximately 20 mg triamcinolone acetonide. MAIN OUTCOME MEASURE: Intraocular pressure. RESULTS: Intraocular pressure readings higher than 21 mmHg, 30 mmHg, 35 mmHg, and 40 mmHg, respectively, were measured in 112 (41.2%) patients, 31 (11.4%) patients, 15 (5.5%) patients, and 5 (1.8%) patients, respectively. Triamcinolone-induced IOP elevation was treated by antiglaucoma medication in all but 3 (1.0%) eyes, for which filtering surgery was performed. Mean IOP started to rise 1 week after injection and returned to baseline values approximately 8 to 9 months after injection. Younger age (P = 0.029) was significantly associated with triamcinolone-induced ocular hypertension. Triamcinolone responders and triamcinolone nonresponders did not vary significantly in gender (P = 0.42), refractive error (P = 0.86), diabetes mellitus status (P = 0.74), and reason for treatment. CONCLUSIONS: These findings may be useful for comparing risks and benefits of intravitreal triamcinolone acetonide therapy.

Aged↗
PubMed2005

Ptosis and orbital fat prolapse after posterior sub-Tenon's capsule triamcinolone injection.

PURPOSE: To describe the occurrence of orbital fat prolapse and blepharoptosis after posterior sub-Tenon (PST) triamcinolone injection. DESIGN: Retrospective review of consecutive case series. PARTICIPANTS: Patients with ptosis and orbital fat herniation after PST triamcinolone injection. METHODS: Charts of all patients with ptosis and orbital fat herniation presenting after PST triamcinolone injection to the oculoplastics service of the Cole Eye Institute between 1999 and 2003 were reviewed. Charts were reviewed for patient age, indication, dates of injections, time to patient complaint or time to referral for ptosis, and marginal reflex distance (MRD1). MAIN OUTCOME MEASURES: Ptosis and orbital fat herniation after PST triamcinolone injection. RESULTS: Eleven patients with a history of ipsilateral PST triamcinolone injections were seen with ptosis and orbital fat prolapse. Ten charts were available for review. Mean patient age was 64 years (range, 45-78 years). Patients underwent 1 to 9 ipsilateral injections, and 2 patients underwent bilateral injections. Patients were seen for ptosis evaluation on average 22.5 months (range, 3-56 months) after the initial injection, and 6.6 months (range, 0-20 months) after the most recent injection. All patients demonstrated significant orbital fat prolapse in conjunction with statistically significant ptosis (P = 0.016). Tissue was obtained in 3 cases. Histologic findings in 1 case showed orbital fat infiltrated by histiocytes that seemed to contain phagocytosed material. CONCLUSIONS: Posterior sub-Tenon triamcinolone injection may cause ptosis associated with orbital fat prolapse. This finding may be a relatively common complication of PST triamcinolone injection. We recommend counseling patients about this risk before PST triamcinolone injection.

Adipose Tissue↗
PubMed1996

Comparison of triamcinolone acetonide nasal inhaler with astemizole in the treatment of ragweed-induced allergic rhinitis.

BACKGROUND: Few clinical trials have directly compared the efficacy of antihistamines with topical nasal corticosteroids. OBJECTIVE: The study was performed to compare the efficacy and safety of triamcinolone acetonide nasal spray at a dose of 110 micro g in each nostril once daily with 10 mg of oral astemizole once daily for the treatment of seasonal allergic rhinitis. METHODS: A multicenter, double-blind, parallel-group study was conducted in 239 patients who were randomized to receive either triamcinolone acetonide or astemizole. A 5-day, drug-free, lead-in period was followed by 4 weeks of double-blind treatment. One hundred four patients treated with triamcinolone acetonide and 105 patients treated with astemizole could be evaluated. RESULTS: Overall, triamcinolone acetonide was more effective than astemizole in reducing total nasal symptoms, nasal stuffiness, nasal itching, and sneezing (p </= 0.01). Triamcinolone acetonide was superior to astemizole at weeks 1, 2, and 3 in reduction of the total nasal symptom score (p </= 0.0401) and in reduction of nasal stuffiness (p </= 0.05). Improvements in individual nasal symptoms (itching, postnasal drip, runny nose, and sneezing) were greater for triamcinolone acetonide at week 2 (p </= 0.01). Ocular symptoms improved from baseline in both groups. When pollen counts were correlated to mean nasal rhinitis scores, the triamcinolone acetonide group showed continued improvement from week 1 to week 2 in nasal symptoms when pollen counts were at their highest. During the same period, patients treated with astemizole failed to show improvement from week 1 to week 2. This study demonstrated that once daily administration of triamcinolone acetonide was more effective than astemizole for controlling nasal symptoms of seasonal allergic rhinitis, especially during the peak pollination period.

Administration, Intranasal↗
PubMed1991

High-dose intramuscular triamcinolone in severe, chronic, life-threatening asthma.

BACKGROUND: Despite oral corticosteroid therapy, some patients with asthma have frequent exacerbations requiring emergency room visits, hospitalization, and occasionally, mechanical ventilation. We compared the effects of high-dose intramuscular triamcinolone with oral prednisone in patients with severe chronic asthma. METHODS: In a double-blind, placebo-controlled, cross-over study that spanned all seasons, we treated 12 patients with high-dose intramuscular triamcinolone (360 mg over the first three days of the treatment period) or low-dose oral prednisone (median dose, 12.5 mg per day throughout the period; range 0 to 30). The two three-month treatment periods were separated by a three-month washout period. During all periods the patients were allowed to take additional doses of prednisone for acute exacerbations of asthma. RESULTS: After receiving triamcinolone, the patients had significantly better peak expiratory flow rates than while receiving prednisone (the average [+/- SEM] weekly percent of the predicted value during the triamcinolone period was 91.5 +/- 6.9, as compared with 75.0 +/- 5.9 for the prednisone period; P less than 0.05). During the prednisone period there were 21 emergency room visits and 10 hospitalizations, but there were none during the triamcinolone period (P less than 0.05). There were two episodes of ventilatory failure during the prednisone period. Total steroid doses were significantly smaller during the triamcinolone period than during the prednisone period (P less than 0.04). Steroidal side effects were more pronounced after treatment with triamcinolone than after treatment with prednisone (P less than 0.1). CONCLUSIONS: We conclude that high-dose intramuscular triamcinolone is more effective than low-dose prednisone in patients with severe, chronic, life-threatening asthma, but steroidal side effects are somewhat worse.

Administration, Oral↗
PubMed2005

Triamcinolone does not alter glial cell activation in the experimentally detached rabbit retina.

AIMS: Retinal detachment induces neural and photoreceptor cell degeneration and fast activation of micro- (immune) and macroglial cells. Hypoxia caused by increased distance between the choriocapillaris and the neural retina, and retinal oedema during detachment, are factors causing gliotic responses and cell degeneration. Triamcinolone may inhibit some cellular responses that accompany hypoxia. Therefore, we investigated whether triamcinolone acetonide may be effective to reduce the gliotic alterations in the detached retina. METHODS: Local retinal detachment in rabbit eyes was created by subretinal injection of sodium hyaluronate, and triamcinolone acetonide (8 mg) was applied intravitreally. Wholecell patch-clamp records from Muller cells and Ca2+ imaging from retinal wholemounts were carried out. Microglial/immune cells in the nerve-fiber layer of retinal wholemounts were labeled with Griffonia simplicifolia agglutinin (GSA) isolectin. Additionally, two morphological parameters which characterize microglial activation/immune cell infiltration were estimated: the cross-sectional area of the somata of the cells in the nerve-fiber layer and the number of cell processes which evolve from the soma. RESULTS: Three days after detachment, gliotic alterations were apparent in Muller cells isolated from both detached and nondetached retinal areas, as indicated by the cellular hypertrophy, by the downregulation of the plasma membrane K+ conductance, and by the upregulation of intracellular Ca2+ responsiveness to stimulation of purinergic P2Y receptors. Intravitreal triamcinolone did not alter these gliotic alterations of Muller cells. Furthermore, triamcinolone could not inhibit the immune cell activation present in detached and attached retinal areas. However, intravitreal triamcinolone led to a strong decrease in the process number of GSA lectin-positive cells from detached retinas. CONCLUSIONS: The results suggest that triamcinolone is ineffective to inhibit gliotic responses in the detached retina. However, the immune cell activation after detachment was partially influenced by triamcinolone.

Animals↗
PubMed2005

Formulation and efficacy of triamcinolone acetonide mouthwash for treating oral lichen planus.

PURPOSE: The stability of a triamcinolone acetonide mouthwash and its efficacy in treating oral lichen planus are described. METHODS: The solubility of triamcinolone acetonide in ethanol, propylene glycol, and glycerin was determined by shaking and equilibrating an excess of triamcinolone acetonide with the solvents for 72 hours. All three solvents were used in formulating a mouthwash. A stock solution of triamcinolone acetonide standard was prepared in ethanol and diluted to yield concentrations of 2, 4, 8, 12, and 16 microg/mL. Analytical sample solutions were prepared by pipetting 0.1 mL of triamcinolone acetonide mouthwash into 10-mL volumetric flasks and diluting to volume with the mobile phase. Accelerated stability studies were conducted by storing the samples in 60-mL amber glass bottles at 45, 60, 70, and 80 degrees C and 75% relative humidity until the triamcinolone concentration decreased markedly. Efficacy was tested by 20 subjects with a clinical diagnosis of and histologically confirmed symptomatic oral lichen planus who were randomized to use the mouthwash (n = 11) or the commercially available triamcinolone acetonide paste (n = 9). RESULTS: The mouthwash had a satisfactory shelf life and was well accepted by patients. Ten of 11 patients treated with the mouthwash for four weeks reported a positive response, and a complete response in signs and symptoms occurred in 4 and 5 of 11 patients, respectively. No significant difference in clinical improvement was observed between groups. CONCLUSION: A triamcinolone acetonide mouthwash had a satisfactory shelf life and was well accepted by patients. It did not have a significantly different therapeutic efficacy from the commercial paste dosage form in the treatment of oral lichen planus.

Adult↗
PubMed2005

Staining of the internal limiting membrane with intravitreal triamcinolone acetonide.

PURPOSE: To evaluate the use of triamcinolone acetonide to stain the internal limiting membrane (ILM) during vitreoretinal surgery. METHODS: A prospective clinical interventional case series study was performed, including 16 patients who underwent pars plana vitrectomy. Seven patients had proliferative diabetic retinopathy with macular edema. Seven patients had epiretinal membranes. One patient had a retinal detachment with a cystoid macular edema and proliferative vitreoretinopathy. One patient had a pseudophakic cystoid macular edema. After vitrectomy, 2 mL triamcinolone acetonide suspension was injected into the vitreous cavity. The ILM was peeled, as it was evidenced by the particles of triamcinolone that adhered to its surface. The ultrastructure of tissue harvested during surgery was analyzed using transmission electron microscopy in selected cases to confirm the presence or absence of ILM. RESULTS: After the injection of triamcinolone, the visualization of the vitreous base and hyaloid was excellent in all patients. The particles of triamcinolone deposited on the retinal surface enabled the ILM to be stained. Once removed, the ILM was clearly distinguishable, floating in the vitreous cavity with particles of triamcinolone adhering to its surface. Ultrastructural analysis of tissue collected during vitrectomy confirmed that the removed tissue represented ILM. CONCLUSION: We observed that triamcinolone acetonide can be useful in staining the internal limiting membrane, thus greatly facilitating the retinal ILM peeling. The absence of particles of triamcinolone on the underlying retina enables the area where the ILM has already been removed to be identified.

Aged↗
PubMed2004

Comparative effect of triamcinolone, nedocromil and montelukast on asthma control in children: A randomized pragmatic study.

Asthma severity can be judged by measurements of symptoms, lung function, and medication requirements. The objective was to compare the effect of a 4-wk monotherapy with low-dose triamcinolone, montelukast and nedocromil on asthma control, lung function, eosinophil blood count, and bronchial hyper-reactivity in children with mild to moderate asthma allergic to dust mite. Two hundred fifty-six children, aged 6-18 yr, with mild to moderate asthma, participated in an 8-wk study. This was a three-arm, randomized no blinding or placebo pragmatic trial comparing the effect of triamcinolone acetonide (400 microg/day), inhaled nedocromil and montelukast sodium on clinical parameters of asthma [score, forced expiratory volume in 1 s (FEV(1))], PC20H, and eosinophil blood count. Two hundred forty-six children completed the study. After 4 wk of treatment with triamcinolone and montelukast, FEV(1) and PC20H significantly increased, and mean total symptoms score and mean number of eosinophil count in serum significantly decreased. Triamcinolone had a stronger effect on PC20H than montelukast. Nedocromil improved total asthma symptoms score and lung function. There was a reduction in the daytime and night-time symptom scores after treatment with all three drugs. Triamcinolone and montelukast had a stronger effect on asthma symptoms than nedocromil. There were statistically significant differences in reduction of nocturnal asthma symptoms between the triamcinolone and nedocromil groups (p < 0.001) and between montelukast and nedocromil (p = 0.001) groups, but not between the triamcinolone and montelukast groups. There was a reduction in beta-agonists use after treatment with all three drugs, with the strongest effect of triamcinolone. The study showed the strongest effect of low-dose inhaled steroids on clinical symptoms, lung function, bronchial hyper-reactivity and eosinophil blood count when compared to other asthma medications.

Acetates↗
PubMed2005

Intravitreal triamcinolone acetonide for treatment of intraocular oedematous and neovascular diseases.

Intravitreal triamcinolone acetonide (IVTA) has increasingly been applied as treatment for various intraocular neovascular and oedematous 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 (VA) has been achieved for intraretinal oedematous diseases such as diffuse diabetic macular oedema, branch retinal vein occlusion, central retinal vein occlusion and pseudophakic cystoid macular oedema. In eyes with various types of non-infectious uveitis, including acute or chronic sympathetic ophthalmia and Adamantiadis-Behcet's disease, VA increased and the degree of intraocular inflammation decreased. Some studies have suggested that intravitreal triamcinolone may be useful as angiostatic therapy in eyes with iris neovascularization and proliferative ischaemic retinopathies. Intravitreal triamcinolone may possibly be helpful as adjunct therapy for exudative age-related macular degeneration (AMD), particularly in combination with photodynamic therapy. In eyes with chronic, therapy-resistant ocular hypotony, intravitreal triamcinolone can induce an increase in intraocular pressure (IOP) 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 IOP 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% of elderly patients within 1 year of injection; postoperative infectious endophthalmitis occurring at a rate of about one per 1000; non-infectious endophthalmitis, perhaps due to a reaction to the solvent agent, and pseudo-endophthalmitis with triamcinolone acetonide crystals appearing in the anterior chamber. Intravitreal triamcinolone injection can be combined with other intraocular surgeries, 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 the resultant benefits decrease after the initial IVTA injection. In non-vitrectomized 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. So far, it has remained unclear whether the solvent agent should be removed, and if so, how.

Choroidal Neovascularization↗
PubMed1997

Comparison of intranasal triamcinolone acetonide with oral loratadine in the treatment of seasonal ragweed-induced allergic rhinitis.

A double-blind, randomized, multicenter, parallel-group controlled study compared the efficacy and safety of intranasal triamcinolone acetonide (220 micrograms/day) and oral loratadine (10 mg/day) in patients with at least two seasons of ragweed-induced seasonal allergic rhinitis. A 28-day screening period, including a 5-day baseline period, preceded a 4-week treatment period. Reduction in rhinitis symptom scores was evident in both groups as early as day 1, with no significant between-group differences during week 1. At weeks 2, 3, and 4, patients treated with triamcinolone acetonide were significantly (P < 0.05) more improved in total nasal score, nasal itch, nasal stuffiness, and sneezing than were patients treated with loratadine. At weeks 3 and 4, rhinorrhea and ocular symptoms were significantly (P < 0.05) more improved from baseline among triamcinolone acetonide patients compared with loratadine patients. There was no significant between-group difference in relief from postnasal drip at any time point. Physicians' global evaluations significantly (P = 0.002) favored triamcinolone acetonide at the final visit, with moderate to complete relief of symptoms attained by 68% of triamcinolone acetonide patients and 59% of loratadine patients. Over the 4-week treatment period, triamcinolone acetonide patients had significantly greater improvement in total nasal score, nasal itch, nasal stuffiness, sneezing, and ocular symptoms. Both treatments were well tolerated, with headache being the most frequently reported drug-related adverse effect in both the triamcinolone acetonide (15%) and loratadine (11%) groups. These results indicate that triamcinolone acetonide is more effective than oral loratadine in relieving the symptoms of ragweed-induced seasonal allergic rhinitis.

Administration, Intranasal↗
PubMed1992

Efficacy of once-a-day intranasal administration of triamcinolone acetonide in patients with seasonal allergic rhinitis.

A 4-week, double-blind, parallel group study compared the safety and efficacy of once-a-day intranasal administration of triamcinolone acetonide (Nasacort) versus placebo in 304 patients (155 adult and 149 adolescent) with seasonal allergic rhinitis. Patients were randomized to receive triamcinolone acetonide (110, 220, or 440 microgram) or placebo once daily each morning. Daily rhinitis symptoms scores, weekly patient and physician global assessments, and weekly nasal eosinophil smears were obtained. In each triamcinolone acetonide group, significant (P less than .05) improvement over placebo was noted in the nasal index (sum of ratings for stuffiness, discharge, and sneezing) by week 1, the first point of analysis, and maintained throughout the study. Triamcinolone acetonide groups also demonstrated significant (P less than .05) improvement over placebo in all individual rhinitis symptoms evaluated. The greatest improvement in symptoms was observed at the 440 microgram dose. A significant decrease in eosinophil counts paralleled clinical improvement in all triamcinolone acetonide groups. Physicians and patients rated triamcinolone acetonide significantly (P less than .05) more effective than placebo. Responses of adult and adolescent patients were comparable. Adverse experiences, clinical laboratory values, and results of physical examinations were unremarkable and comparable between the triamcinolone acetonide and placebo groups. We conclude that triamcinolone acetonide is safe, well tolerated, and superior to placebo as a once-a-day treatment for seasonal allergic rhinitis.

Administration, Intranasal↗
PubMedDate not supplied

Preliminary experience with triamcinolone acetonide during pregnancy.

Although inhaled corticosteroids have been recommended, there are no published reports of triamcinolone acetonide therapy for asthma during pregnancy. The objective of this study was to report our experience with triamcinolone acetonide during pregnancy. This was a retrospective cohort study in a tertiary care urban hospital. We compared birth weights and the proportion of subjects hospitalized for asthma exacerbations among pregnant women receiving inhaled triamcinolone acetonide, inhaled beclomethasone dipropionate, and oral theophylline. The mean triamcinolone acetonide group (n = 15) birth weight was 502 g more than the beclomethasone group (n = 14) and 316 g more than the theophylline group (n = 25); however, these differences were not statistically significantly. Fewer patients treated with triamcinolone acetonide (n = 5, 33%) required hospital admissions for asthma exacerbations compared to those treated with beclomethasone (n = 11, 79%; P < 0.05) but not theophylline (n = 7, 28%; P = NS). Our preliminary data suggest that triamcinolone acetonide appears to be at least as efficacious for the treatment of asthma during pregnancy as is beclomethasone. These results should be confirmed by a clinical trial to further evaluate the safety and efficacy of inhaled triamcinolone acetonide during pregnancy.

Administration, Inhalation↗
PubMed1994

Nasal mucosal inflammation has no effect on the absorption of intranasal triamcinolone acetonide.

The potential for enhanced systemic absorption of intranasal triamcinolone acetonide was explored in patients with inflamed nasal mucosa. Twelve allergic rhinitis patients with documented nasal inflammation, and 12 healthy volunteers, each received a single, therapeutic, 400-micrograms dose of triamcinolone acetonide in each nostril. Blood was obtained at fixed time points after the dose, and plasma concentrations of triamcinolone acetonide were determined by radioimmunoassay. There were no statistically significant differences in any of the derived pharmacokinetic parameters (maximum plasma triamcinolone acetonide concentrations [Cmax], time to maximum plasma triamcinolone concentrations [Tmax], elimination half-life [t1/2], and area under the plasma concentration-time curve [AUC0-12] from 0 to 12 hours) between treatment groups. A once-a-day, chronic regimen (6 weeks) of triamcinolone acetonide was also administered to five patients with allergic rhinitis. Pharmacokinetic parameters were similar to the parameters derived from healthy volunteers after acute administration. There was no evidence of drug accumulation. The results of this study indicate that acute and chronic intranasal administration. The results of this study indicate that acute and chronic intranasal administration of therapeutic doses of triamcinolone acetonide to patients with inflamed nasal mucosa does not result in enhanced systemic drug absorption or accumulation.

Absorption↗
PubMedDate not supplied

Comparison of intranasal triamcinolone acetonide with oral loratadine for the treatment of patients with seasonal allergic rhinitis.

This multicenter, double-blind, randomized, controlled, parallel-group study compared the safety and efficacy of intranasal triamcinolone acetonide with oral loratadine in relieving symptoms of ragweed-induced seasonal allergic rhinitis. Patients from community-based allergy practices with a history of at least two seasons of seasonal allergic rhinitis verified by a positive skin test received either once-daily treatment with intranasal triacinolone acetonide 220 micrograms plus 1 placebo capsule or oral loratadine 10 mg plus placebo nasal spray. Other medications for rhinitis were prohibited. Changes in rhinitis symptoms were assessed by using patient evaluations, physician global evaluations, and withdrawal rates. Efficacy was evaluated in 274 of 298 patients randomized to treatment (134 to triamcinolone acetonide and 140 to loratadine). Mean total nasal symptom scores for weeks 1, 2, 3, and 4 and the overall score showed greater improvement (P = 0.001) with triamcinolone acetonide than with loratadine. Improvement in all rhinitis symptoms was significantly greater with triamcinolone acetonide than with loratadine; there was a trend for greater improvement in ocular symptoms with triamcinolone acetonide. Physicians' global evaluations indicated triamcinolone acetonide provided moderate-to-complete relief in 78% of patients compared with 58% of loratadine-treated patients (P < or = 0.0001). Both treatments were well tolerated; headache was the most commonly reported adverse event in both groups. Intranasal triamcinolone acetonide was significantly more effective than oral loratadine in relieving the symptoms of seasonal allergic rhinitis.

Administration, Intranasal↗
PubMed2006

Intravitreal triamcinolone acetonide concentration after subtenon injection.

PURPOSE: To determine concentration of intravitreal triamcinolone after subtenon injection. DESIGN: Prospective series of vitrectomy candidates and laboratory investigation. METHODS: Twenty eyes of 20 patients received subtenon injections of triamcinolone acetonide, 40 mg, before vitrectomy surgery. Exclusion criteria included previous history of vitrectomy, triamcinolone injection, and retinal detachment. Posterior subtenon injections were performed using the standard technique. Undiluted vitreous specimens were obtained at the time of vitrectomy, which was performed from one to 29 days after subtenon injection. Intravitreal triamcinolone concentration was determined by high-performance liquid chromatography. RESULTS: No complications were associated with subtenon injections. Intravitreal triamcinolone concentrations varied considerably, from zero in five eyes to a high of 4.94 microg/ml. CONCLUSIONS: Intravitreal triamcinolone concentrations vary considerably after subtenon injection. The findings indicate that subtenon injection can be a method for administering intravitreal triamcinolone acetonide that is comparable, in some cases, to the levels achieved after intravitreal injection.

Chromatography, High Pressure Liquid↗