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PubMed1997

Effects of triamcinolone on brain and cerebrospinal fluid apolipoprotein E levels in rats.

The effects of the short term administration of triamcinolone (0.5 mg per 100 g body weight, 5 days) on apolipoprotein E and A-I concentrations in cerebrospinal fluid (CSF), brain extract and serum were studied in male Wistar rats using enzyme immunoassays. ApoE was significantly increased by triamcinolone in apoE-rich HDL1 in serum; 40+/-13 (mean+/-SD) vs. 68+/-23 mg/dl (15 saline-treated rats vs. 11 triamcinolone-treated rats)(P<0.01), which was paralleled by an increase in serum apoA-I (76+/-21 vs. 184+/-24 mg/dl), while serum lipids also increased significantly. No significant difference was observed in the apoE concentrations in CSF (296+/-170 vs. 269+/-67 microg/dl) or brain extract (5.0+/-1.6 vs. 5.7+/-1.8 microg/g wet weight). The apoA-I concentrations found in CSF and brain extract were much lower than those for apoE and were not appreciably affected by triamcinolone: 7.7+/-5.5 vs. 4.5+/-3.1 microg/dl for CSF and <0.5 vs. <0.5 microg/g wet weight for brain extract. The apo E metabolism in the rat central nervous system appears to be refractory to the short term administration of triamcinolone and to changes in the serum lipoprotein metabolism. ApoA-I appears unlikely to play a significant role in the rat central nervous system.

Animals↗
PubMed1989

Psoriasis therapy: comparative studies with a hydrocolloid dressing, plastic film occlusion, and triamcinolone acetonide cream.

The efficacy of a new hydrocolloid dressing occlusion, alone or with 0.1% triamcinolone cream, was compared with triamcinolone acetonide alone or under plastic film occlusion in the treatment of localized plaque-type psoriasis. Thirty-eight patients were randomly assigned to one of four bilateral, paired-comparison treatment groups. Patients underwent 3 weeks of treatment, after which they were followed up for an additional week. After 3 weeks hydrocolloid occlusion with triamcinolone acetonide yielded a significantly better response than the cream alone or the hydrocolloid dressing alone, but the new dressing was comparable to a plastic film occlusive dressing of triamcinolone acetonide. After discontinuation of treatment, however, the sites that had been treated with hydrocolloid-occluded triamcinolone acetonide retained the better results. Topical steroids under hydrocolloid occlusive dressing may be a useful alternative to steroids alone for treatment of localized recalcitrant psoriasis.

Administration, Topical↗
PubMed2000

Enhanced bioavailability by buccal administration of triamcinolone acetonide from the bioadhesive gels in rabbits.

The pharmacokinetics and bioavailability of triamcinolone acetonide were determined to investigate buccal absorption from the mucoadhesive gels in rabbits. The enhancing effect of sodium deoxycholate as an enhancer on the buccal absorption of triamcinolone acetonide from the mucoadhesive gels was evaluated in rabbits. Thus, 2 mg/kg of triamcinolone acetonide was administered from the mucoadhesive gels containing an enhancer (enhancer group) or not (control group) via the buccal routes and compared with intravenous routes (1 mg/kg, i.v. group). AUC of the control, enhancer and i.v group were 2374+/-915, 3778+/-1721 and 3945+/-2085 h ng/ml, respectively, and the absolutive bioavailability of enhancer or i.v to control group were 159.14 or 332.35%, respectively. The average C(max) of control and enhancer group were 263+/-159 and 362+/-201 ng/ml, and the mean T(max) of the control group and enhancer group were 5.00+/-1.67 and 4.33+/-0.82 h, respectively, but there was no significant difference. As the triamcinolone acetonide gels containing sodium deoxycholate as an enhancer was administered to rabbits via the buccal routes, the relative bioavailability showed about 1.59-fold compared with the control group. Buccal administration of triamcinolone acetonide gels containing sodium deoxycholate as an enhancer to rabbits showed a relatively constant, sustained blood concentration with minimal fluctuation.

Adhesives↗
PubMed2006

Effectiveness of instillation of triamcinolone acetonide into the middle ear for eosinophilic otitis media associated with bronchial asthma.

BACKGROUND: Eosinophilic otitis media (EOM) is a newly recognized middle ear disease found in asthmatic patients. EOM is characterized by a highly viscous middle ear effusion that contains many eosinophils and is extremely unresponsive to conventional treatments for common otitis media. To our knowledge, no systemic study regarding the efficacy of treatments for EOM has been performed. OBJECTIVE: To determine the effectiveness of instillation of triamcinolone acetonide, which is a suspension of steroids, into the mesotympanum and eustachian tube as a treatment for patients with EOM. METHODS: We studied the efficacy of the instillation of triamcinolone acetonide in 43 ears of 24 patients with EOM. Efficacy was evaluated according to the length of the period without middle ear effusion or otorrhea. We also determined the otomicroscopic findings and the hearing levels before and after therapy. For controls, 27 ears of 14 patients treated by topical administration of betamethasone were similarly evaluated. RESULTS: The middle ear effusion or otorrhea was controlled for more than 3 weeks after 1 instillation of triamcinolone acetonide in 35 ears, and the efficacy rate (81%) was significantly higher than that in the controls (7 ears, 26%). In the triamcinolone acetonide group, the average air conduction hearing level at the speech frequency range was significantly improved, and deterioration of the bone conduction hearing threshold was rarely found during therapy. CONCLUSION: The instillation of triamcinolone acetonide into the mesotympanum and eustachian tube is an effective treatment for patients with EOM.

Adult↗
PubMed1999

Efficacy of supratarsal dexamethasone versus triamcinolone injection in recalcitrant vernal keratoconjunctivitis.

PURPOSE: To compare the efficacy of supratarsal injection of short acting dexamethasone sodium phosphate versus intermediate acting triamcinolone acetonide as a new therapeutic modality for treating eyes with recalcitrant vernal keratoconjunctivitis (VKC). METHODS: The study was a prospective, randomized, double blind, case controlled trial, including 38 eyes of 19 patients with recalcitrant VKC. Except for two initial patients who received supratarsal injection of triamcinolone acetonide in both the eyes, one eye of each patient was randomly assigned to receive either 2 mg of dexamethasone sodium phosphate or 20 mg of triamcinolone acetonide. RESULTS: Both the drugs were equally effective with no statistically significant difference in the mean time of resolution of cobblestone papillae, limbal edema, shield ulcer, SPK and relief of symptoms. The recurrence rate of disease was, however, lower following triamcinolone acetonide injection. CONCLUSIONS: Supratarsal injection of corticosteroid is a cheap, effective and safe modality of treatment for managing eyes with recalcitrant VKC. Both short acting dexamethasone and intermediate acting triamcinolone acetonide are equally effective.

Adolescent↗
PubMed2006

Intravitreal triamcinolone acetonide for treatment of persistent macular oedema in branch retinal vein occlusion.

BACKGROUND: To evaluate the efficacy of intravitreal triamcinolone acetonide injection on persistent macular oedema in branch retinal vein occlusion that fails to respond to previous laser photocoagulation. MATERIAL AND METHODS: A total of 19 eyes of 19 patients with persistent macular oedema due to branch retinal vein occlusion were treated with 8 mg/0.2 ml of intravitreal triamcinolone acetonide injection. The main outcome measures included best-corrected visual acuity, intraocular pressure, and macular oedema map values of Heidelberg Retinal Tomograph II (HRT II) before and after intravitreal triamcinolone injection. RESULTS: The mean follow-up time was 6.2+/-1.0 months. The mean baseline best-corrected logarithm of minimal angle of resolution (LogMAR) value for visual acuities of the patients before intravitreal triamcinolone injection was 1.01+/-0.16. After treatment, it was 0.55+/-0.22 at the 1-month, 0.56+/-0.22 at 3-month, and 0.62+/-0.22 at the last visits and the differences were statistically significant when compared with baseline values (for each, P<0.001). The mean oedema map values on HRT II significantly decreased by 28.5% at 1-month, 23.8% at 3-month, and 23.8% at the last visit when compared with preinjection values (for each, P<0.001). Intraocular pressure elevation exceeding 21 mmHg was observed in 26.3% of eyes at 1-month, 15.7% at 3-month, and 5.2% at the last visit, but was controlled with topical anti-glaucomatous medications in all eyes. CONCLUSION: Intravitreal triamcinolone acetonide application is a promising approach in the treatment of persistent macular oedema due to branch retinal vein occlusion non-respondent to laser photocoagulation.

Aged↗
PubMed1972

Influence of glucagon, 6-N,2'-O-dibutyryladenosine 3':5'-cyclic monophosphate and triamcinolone on the arginine synthetase system in perinatal rat liver.

1. The administration of triamcinolone (19-190mug/animal) to postnatal rats increased the arginine synthetase system activity 1.2-2.5-fold above control values 24h after exposure to the hormone. Cortisol (hydrocortisone), however, increased the arginine synthetase system activity only when larger (190mug/animal) or repeated daily doses were given. Glucagon (100mug/animal) stimulated arginine synthetase system activity only after the second postnatal day. None of these agents increased the activity in 19.5-21.5-day foetuses after intrauterine administration. 2. The viability of foetal rat liver explants maintained in organ culture for up to 54h was validated both by ultramicroscopic examination and by incorporation of radioactive leucine and orotic acid. 3. In organ cultures of foetal rat liver explants (18.5 days to term), triamcinolone (20mug/ml of medium) evoked a 2.8-4.3-fold increase after 24h of incubation. This increase was completely inhibited by actinomycin D (25mug/ml) or cycloheximide (10mug/ml). Cortisol (5-50mug/ml) or glucagon (0.067-67mug/ml) also increased the arginine synthetase system activity above the respective control values, but there was no increase in activity with insulin (0.05-0.25i.u./ml). 4. Maximum concentrations of glucagon (67mug/ml), dibutyryl cyclic AMP (6-N,2'-O-dibutyryladenosine 3':5'-cyclic monophosphate) (0.1mm) and triamcinolone (20mug/ml) incubated for 24h with foetal rat liver explants each produced between a two-and three-fold increase in the activity of the arginine synthetase system. Combinations of maximum amounts of glucagon and the cyclic nucleotide did not produce a greater effect than either agent alone. However, the combination of dibutyryl cyclic AMP with triamcinolone appeared to produce somewhat less than additive effects. 5. The effects of the cyclic nucleotide and triamcinolone were evident after 12h of incubation and increased steadily throughout the 24h of observation. This time-course of increased enzyme activity is very much slower than that reported for the induction of other enzymes in explant cultures of foetal rat liver.

Adenine Nucleotides↗
PubMed2003

Effect of nasal triamcinolone acetonide on lower airway inflammatory markers in patients with allergic rhinitis.

BACKGROUND: Allergic rhinitis (AR) and asthma are commonly associated, and similar underlying inflammatory processes link both diseases. AR, even in the absence of asthma, is associated with increased levels of exhaled nitric oxide (ENO) and hydrogen peroxide (H(2)O(2)) in exhaled breath condensate, 2 noninvasive markers of lower airway inflammation. OBJECTIVE: We sought to evaluate the effect of treatment with the nasal steroid triamcinolone acetonide on ENO and exhaled H(2)O(2) in subjects with AR. METHODS: We allocated 23 subjects in a randomized, double-blind, parallel-controlled fashion to 4-week treatment with triamcinolone acetonide (220 microg/d) or matching placebo. RESULTS: ENO levels were greater in the subgroup with concomitant asthma (16/23 subjects) and decreased significantly with triamcinolone acetonide treatment in this subgroup of patients in comparison with patients receiving placebo. Breath condensate levels of H(2)O(2) were higher in patients with AR without asthma than in those with asthma but decreased significantly with triamcinolone acetonide treatment in both subgroups. No changes were observed in bronchial hyperresponsiveness, nasal and asthma symptoms, or peak expiratory flow with active treatment or placebo. CONCLUSION: We conclude that treatment of AR with triamcinolone acetonide results in decrease of 2 noninvasive markers of lower airway inflammation, ENO and H(2)O(2), supporting that upper and lower airway inflammation should be seen as a continuum in subjects with AR with and without asthma. ENO might be a more specific marker of the lower airway inflammation present in asthma.

Administration, Intranasal↗
PubMed2006

Intravitreal triamcinolone acetonide treatment for serpiginous choroiditis.

PURPOSE: To report the efficacy of intravitreal triamcinolone acetonide injection for acute treatment of a patient with serpiginous choroiditis. METHODS: A 50-year-old male patient with serpiginous choroiditis presenting with the complaint of decreased visual acuity in his right eye for the last 10 days. The best corrected visual acuity (BCVA) of the patient was counting finger from 1 meter. Fundus examination and fundus fluorescein angiography of right eye revealed active macular choroiditis in right eye. Intravitreal triamcinolone acetonide (4 mg/0.1 ml) was injected into vitreous, and the patient was followed with visual acuity testing, intraocular pressure measurement, and fundus examination, including fundus fluorescein angiography. RESULTS: Visual acuity of the patient improved to 20/100 after 2 weeks in spite of the triamcinolone crystals, and to 20/50 after 4 weeks with a single dose intravitreal triamcinolone acetonide injection. Complete resolution of the active lesion has been maintained during the 6 months of follow-up. CONCLUSIONS: Single dose intravitreal triamcinolone acetonide injection is sufficient for controlling the active lesions in serpiginous choroiditis. It needs further evaluation as an alternative treatment for achieving rapid and significant visual acuity recovery.

Choroiditis↗
PubMed1998

Intraarticular triamcinolone acetonide for pain control after arthroscopic knee surgery.

UNLABELLED: Intraarticular corticosteroids provide valuable local therapy for chronic joint pain caused by inflammatory joint diseases. In this inpatient study, we evaluated the effect of intraarticular triamcinolone acetonide on acute pain after arthroscopic knee surgery. Sixty patients who underwent arthroscopic knee surgery under spinal anesthesia were enrolled into this double-blind, randomized trial. At the end of surgery, Group 1 (n = 30) received intraarticular triamcinolone acetonide 10 mg in isotonic saline 20 mL, and Group 2 (n = 30) received intraarticular isotonic saline 20 mL. After surgery, pain was assessed by using a visual analog scale. The time to first analgesic request (IV morphine) was recorded, and the proportion of patients requiring rescue analgesia was calculated. The results demonstrated that patients in Group 1 had lower pain scores than those in Group 2 from 6 to 24 h postoperatively (P < 0.05 to P < 0.01). From 6 h to 24 h, no patient in Group 1, compared with 53% of patients in Group 2, requested rescue analgesia (P < 0.001). We conclude that intraarticular triamcinolone acetonide provides a valuable local therapy of acute joint pain after arthroscopic knee surgery. IMPLICATIONS: The value of intraarticular triamcinolone acetonide in the management of pain after arthroscopic knee surgery has been evaluated. Patients who received intraarticular triamcinolone acetonide 10 mg at the end of surgery had lower pain scores and used less systemic analgesia than the saline control group. These data are important to the clinical use of this new therapy.

Adult↗
PubMed2003

Isolating triamcinolone acetonide particles for intravitreal use with a porous membrane filter.

PURPOSE: To report a new, simple, rapid method to isolate triamcinolone acetonide particles and to remove additives from its commercially available suspension (Kenacort-A) for intravitreal use. METHODS: The contents of a Kenacort-A vial (40 mg triamcinolone acetonide suspended in 1.0 mL vehicle) were loaded into a syringe and passed through a porous membrane filter with 0.45-microm pores. The filter was then backflushed with distilled water to yield a vehicle-poor suspension of triamcinolone acetonide in the initial syringe. This filtration and backflush procedure was repeated four times, and each waste filtrate was subjected to high-performance liquid chromatography to identify benzyl alcohol, a preservative in the vehicle. Gel permeation chromatography was also used to determine the degree to which carboxymethylcellulose, one of the two suspending agents in the vehicle, permeated the membrane filter. Although 7.5 mg/mL high-viscosity carboxymethylcellulose hardly passed through the 0.45-microm pore filter, it passed through the 5.0-microm pore filter easily. Therefore, a 5.0-microm pore filter was used in this study. RESULTS: By using a 0.45-microm porous membrane filter, 99.7% of the benzyl alcohol can be eliminated. By using a 5.0-microm porous membrane filter, but not by using a 0.45-microm porous membrane filter, 88.1% of the high-viscosity carboxymethylcellulose can be eliminated. CONCLUSIONS: The filtration and backflush procedure using the 5.0-microm porous membrane filters is useful during vitrectomy to reduce the preparation time of triamcinolone acetonide suspension. Also, this method of reducing additives may be more helpful when using triamcinolone as a therapeutic agent for intravitreal depot use, because there is no washout effect when it is used in this manner.

Chromatography, Gel↗
PubMedDate not supplied

Intravitreal triamcinolone acetonide for diabetic macular edema.

PURPOSE: Intravitreal injection of triamcinolone acetonide has been advocated to treat exudative diabetic macular edema. The purpose of the study was to evaluate the clinical outcome of an intravitreal injection of triamcinolone acetonide as treatment for diffuse diabetic macular edema. METHODS: This study was a retrospective, interventional, clinical case series examining 210 eyes of 174 patients who received an intravitreal injection of 1 or 4 mg of triamcinolone acetonide for treatment of diffuse diabetic macular edema. Inclusion criteria were clinically significant macular edema, visual acuity loss, and leakage shown by fluorescein angiography. Main outcome measures were visual acuity and intraocular pressure. Mean follow-up time +/- SD was 6.6 +/- 3.1 months. RESULTS: In the study group, visual acuity improved significantly (P < 0.001) from a median of 20/200 (mean logMAR, 0.92) at baseline to 20/80 (mean logMAR, 0.82) at 6 months. Mean intraocular pressure +/- SD increased from 15.4 +/- 3.4 mmHg (median, 16 mmHg; range, 6-26 mmHg) to a maximal value of 20.4 +/- 6.2 mmHg (median, 19 mmHg; range, 12-51 mmHg) during the follow-up period. Complications included culture-negative sterile endophthalmitis in six cases and cataract extraction in five eyes. CONCLUSIONS: Intravitreal injection of 1 to 4 mg of triamcinolone acetonide may benefit patients by improving visual acuity in eyes with clinically significant diabetic macular edema. This study did not provide significant evidence to justify its routine use in clinical practice for all patients with diabetic macular edema. A randomized clinical trial on this issue would provide more conclusive evidence and help identify those patients most likely to benefit from intravitreal triamcinolone acetonide.

Adult↗
PubMed2006

Selective laser trabeculoplasty for intraocular pressure elevation after intravitreal triamcinolone acetonide injection.

PURPOSE: Intravitreal injection of triamcinolone acetonide has increasingly become a therapeutic option for neovascular, inflammatory, and edematous intraocular diseases. A common side effect of this treatment is a steroid-induced elevation of intraocular pressure. In most of these patients, the rise in intraocular pressure can be treated topically. Those cases that cannot be treated medically have been treated with filtering surgery. This report presents a case of intraocular pressure elevation after intravitreal triamcinolone acetonide injection that was successfully treated with selective laser trabeculoplasty. CASE REPORT: A 63-year-old white man presented with brow ache on the right side approximately 3 months after undergoing intravitreal injection of triamcinolone acetonide for diabetic macular edema in the right eye. Applanation tonometry revealed an intraocular pressure of 45 mm Hg in the involved eye. After initial treatment with topical medications, the patient underwent selective laser trabeculoplasty. Now, 6 months postlaser treatment, the intraocular pressure in the involved eye is stable at 15 mm Hg without topical medications. CONCLUSIONS: A steroid-induced elevation of intraocular pressure is a common and widely reported side effect of treatment with intravitreal triamcinolone acetonide. This case report suggests that selective laser trabeculoplasty has potential as first- or second-line therapy for intraocular pressure elevation after intravitreal triamcinolone acetonide injection.

Diabetic Retinopathy↗
PubMed2004

Clinical trial to compare efficacy and side-effects of injection of posterior sub-Tenon triamcinolone versus orbital floor methylprednisolone in the management of posterior uveitis.

AIM: To compare the efficacy and side-effects of posterior sub-Tenon injection of triamcinolone acetonide (Kenalog) with orbital floor injection of methylpredisolone acetate (Depomedrone) in the management of posterior uveitis. METHODS: Non-randomized comparative prospective clinical study. Sixty-four eyes from 60 consecutive patients with non-infectious posterior uveitis requiring treatment were allocated on an alternate 1:1 basis to receive either orbital floor methylprednisolone or sub-Tenon triamcinolone using standard procedures and assessed at 6 and 12 weeks. RESULTS: After five eyes of five patients who had received the same treatment bilaterally were excluded from the statistical analysis, 14 out of 29 eyes treated with orbital floor methylprednisolone and 10 out of the 30 eyes given sub-Tenon triamcinolone improved at 6 weeks. There was no statistically significant difference in the improvement rate between the two groups. However, two patients given triamcinolone had prolonged upper lid ptosis, which required surgery, and another two developed markedly raised intraocular pressure, neither of which occurred in the methylprednisolone-treated group. CONCLUSIONS: Although the two drugs and routes compared were of similar efficacy, lid ptosis occurred in the triamcinolone-treated but not the methylprednisolone group. This should be borne in mind when choosing the preferred route of delivery of periocular corticosteroid in the treatment of posterior uveitis.

Blepharoptosis↗
PubMed1985

Intramuscular triamcinolone acetonide in chronic severe asthma.

Seventeen subjects with chronic severe asthma completed a 48 week prospective, double blind study with crossover of treatment at 24 weeks, in which triamcinolone acetonide 80 mg intramuscularly every four weeks was compared with oral prednisolone 10 mg daily. Spirometry, twice daily measurements of peak expiratory flow rate, and self assessment of asthma symptom scores showed significant improvement during triamcinolone treatment; less extra prednisolone was required and there was significant weight loss. Two patients withdrew, one because of dissatisfaction with prednisolone and one because of side effects while taking triamcinolone. Three were withdrawn, one with proximal muscle weakness and two because of intercurrent illness. Adrenal suppression, bruising, and hirsuitism were worse with triamcinolone, other side effects being comparable. On completion of the study 16 of the 17 patients opted to continue taking triamcinolone acetonide. This treatment is an important addition to the therapeutic options available for chronic severe asthma.

Administration, Oral↗
PubMed1993

Triamcinolone and prednisolone affect contractile properties and histopathology of rat diaphragm differently.

Diaphragm atrophy and weakness occur after administration of massive doses of corticosteroids for short periods. In the present study the effects of prolonged administration of moderate doses of fluorinated and nonfluorinated steroids were investigated on contractile properties and histopathology of rat diaphragm. 60 rats received saline, 1.0 mg/kg triamcinolone, or 1.25 or 5 mg/kg i.m. prednisolone daily for 4 wk. Respiratory and peripheral muscle mass increased similarly in control and both prednisolone groups, whereas triamcinolone caused severe muscle wasting. Maximal tetanic tension averaged 2.23 +/- 0.54 kg/cm2 (SD) in the control group. An increased number of diaphragmatic bundles in the 5-mg/kg prednisolone group generated maximal tetanic tensions < 2.0 kg/cm2 (P < 0.05). In addition, fatigability during the force-frequency protocol was most pronounced in this group (P < 0.05). In contrast, triamcinolone caused a prolonged half-relaxation time and a leftward shift of the force-frequency curve (P < 0.05). Histological examination of the diaphragm showed a normal pattern in the control and 1.25-mg/kg prednisolone group. Myogenic changes, however, were found in the 5-mg/kg prednisolone group and, more pronounced, in the triamcinolone group. Selective type IIb fiber atrophy was found in the latter group, but not in the prednisolone groups. In conclusion, triamcinolone induced type IIb fiber atrophy, resulting in reduced respiratory muscle strength and a leftward shift of the force-frequency curve. In contrast, 5 mg/kg prednisolone caused alterations in diaphragmatic contractile properties and histological changes without fiber atrophy.

Animals↗
PubMed2002

A new solution-based intranasal triamcinolone acetonide formulation in patients with perennial allergic rhinitis: how does the pharmacokinetic/pharmacodynamic profile for cortisol suppression compare with an aqueous suspension-based formulation?

The present study was undertaken to describe the pharmacokinetics of a new solution-based intranasal triamcinolone acetonideformulation (Tri-Nasal) in patients with perennial allergic rhinitis and to use a pharmacokinetic/pharmacodynamic (PK/PD) simulation approach to compare the potential effects on plasma cortisol with that of an aqueous suspension-based nasal triamcinolone acetonide formulation (Nasacort AQ). Data from an open-label, randomized, three-way crossover study in patients with perennial allergic rhinitis receiving three doses (100, 200, and 400 microg) of a nasal solution-based triamcinolone acetonide formulation (Tri-Nasal) over 7 days were used to describe the pharmacokinetics of this formulation. Available literature data for a suspension-based aqueous triamcinolone acetonide formulation (Nasacort AQ) were used to describe its pharmacokinetic profile after similar single doses of 110, 220, and 440 microg. A PK/PD simulation approach was used to predict the anticipated cumulative cortisol suppression (CCS) of these two formulations. These simulations suggested a cortisol suppression of 8% to 16% for the single and steady-state doses of the solution-based product. Similar CCS estimates were predicted for equivalent doses of the aqueous suspension-based triamcinolone acetonide formulation with no difference between both formulations. Post hoc power analysis suggested that the predicted cortisol suppression is not likely to be significant for either preparation, including the clinically recommended doses of 200 and 220 microg of the solution-based and suspension-based formulations, respectively. In summary, based on the results of this PK/PD simulation, the plasma levels observed afternasal administration of the solution or the aqueous suspension are unlikely to induce a clinically relevant cortisol suppression, especially for the recommended dosing regimens of 200 and 220 microg/day.

Administration, Intranasal↗
PubMed2003

Intravitreal triamcinolone acetonide injection in blind painful eyes. Intraocular steroids as a treatment for blind painful red eyes.

PURPOSE: Phthisis bulbi results from different ocular conditions. We evaluated intravitreal triamcinolone acetonide as a treatment option in blind painful eyes. METHODS: Thirty-one patients with unilateral phthisis were randomly divided into two groups. Group A received 0.3 ml (12.5 mg) triamcinolone acetonide intravitreally and Group B 0.3 ml balanced salt solution after retrobulbar anesthesia. Treatment success was assessed by subjective response to pain and clinically by biomicroscopic evaluation of conjunctival congestion. Tonometry was done before and after treatment. Follow-ups were at 24 hours, 3 weeks, 3 and 6 months, and 1 and 2 years. RESULTS: Throughout the two-year follow-up, only two patients in Group A reported pain after the procedure and were retreated, one at week 4 and the other at week 7. Conjunctival congestion was significantly lower in Group A. Two patients with hypotony before treatment had normal tension after triamcinolone. All Group B patients were reinjected with triamcinolone because pain continued after balanced salt solution injection. No severe complications were found. CONCLUSIONS: Intravitreal triamcinolone acetonide may be effective and safe for treating blind painful eyes.

Adolescent↗