Trade name:
Triamcinolone

International name:
Triamcinolone (Triamcinolone)

Group affiliation:
Glucocorticosteroid

Description of the active substance (INN):
Triamcinolone

Dosage form:
pills
see also:
Triamcinolone; nazalny fine

Pharmacological actions:
CSG, inhibits the release of interleykina1, interleykina2, interferon gamma of lymphocytes and macrophages. Has anti-inflammatory, protiwallergicescoe, desencibilizirutee, anti-shock, anti-toxic and immunodepressive action. Suppresses the release of pituitary ACTH and beta-lipotropin, but does not reduce the concentration of circulating beta-endorphin. Inhibits the secretion of TSH and FSH. Increases the excitability of the central nervous system, reduces the number of lymphocytes and eosinophils increases - stimulates production of erythrocytes (erythropoietin). Interacts with specific cytoplasmic receptors and form a complex penetration in the nucleus of cells and stimulates the synthesis of Mrna; the latter induces the formation of proteins, including lipokortina, oposreduth cell effects. Lipokortin oppressing fosfolipazu A2, suppress the formation of arachidonic acid and suppresses the synthesis of endoperekisey, Ng, lakotrienov, contributing to the processes of inflammation, allergies, etc. Protein metabolism: it reduces the amount of protein in the plasma (by globulin) with the increase of the coefficient of albumin / globulin, increases the synthesis of albumin in the liver and kidneys; increases catabolised protein in muscle tissue. The exchange of lipids: increases the synthesis of fatty acids and TG, redistributes fat (fat accumulation mainly in the area of ​​the shoulder, face, abdomen), leads to the development of hypercholesterolemia. Carbohydrate metabolism: increases the absorption of carbohydrates from the digestive TRACT increases the activity of glucose-6-phosphatase, leading to the increase of glucose from the liver into the blood, increases the activity of фосфоэнолпируваткарбоксилазы and synthesis of the aminotransferaz, leading to the activation of gluconeogenesis. The water-electrolytic exchange: the delay of the Na + and water in the body, stimulates the excretion of K + (ISS activity), reduces the absorption of Ca2 + from the digestive TRACT, "washes away" the Ca2 + from the bones, increases the excretion of Ca2 + kidneys. The anti-inflammatory effect is associated with inhibition of release of mediators of inflammation eosinophils; induction lipokortina education and reduce the number of fat cells, generating hyaluronic acid; with a decrease in the permeability of the capillaries; stabilization of cell membranes and membrane organell ( especially lysosomal). Protiwallergiceski effect develops as a result of the suppression of the synthesis and secretion of mediators allergies, braking release of sensitised fat cells and bazofilov gistamina and other biologically active substances, reduce the number of circulating basophils, the suppression of the development of lymphoid and connective tissue , reducing the number of T-and B-cells, mast cells, reducing the sensitivity of the effector cells for mediators allergy, oppression formation, changes in the immune response. In COPD action is primarily based on inhibition of inflammatory processes, oppression development or prevention of oedema of the mucous membranes, braking eosinophilic infiltration submucosal layer of the epithelium of the bronchi, the sediment in the mucous membrane of the bronchi circulating immune complexes, as well as braking erozirovaniya and desquamation of mucous membrane. Increases the sensitivity of the beta-adrenergic receptors of the bronchi of small and medium-caliber to endogenous catecholamines and exogenous sympathomimetics, reduces the viscosity of mucus by oppression, or the reduction of its products. Anti-shock and anti-toxic effect associated with a rise in HELL (due to the increase in the concentration of circulating catecholamines and restore sensitivity to him adrenoreceptors, as well as vasoconstriction), decrease in the permeability of the vascular wall, oxidant properties, activation of liver enzymes involved in the metabolism of endo-and xenobiotics. Immunodepressivny effect is due to inhibition of the release of cytokines (interleykina1, interleykina2;? Interferon) from the cells and macrophages. Suppresses the synthesis and secretion of ACTH and a second time - the synthesis of endogenous CORTICOSTEROID. Inhibits connective tissue reactions in the course of the inflammatory process and reduces the possibility of formation of scar tissue. For anti-inflammatory activity triamcinolone close to hydrocortisone sulfasalazine, triamcinolone acetonide in six times more. ISS activity is practically absent. The maximum effect is observed in 1-2 hours, the duration of 2.5 days.

Indications:
System diseases of connective tissue (SLE, scleroderma, periarteritis nodosa, dermatomyositis, rheumatoid arthritis). Acute and chronic inflammatory diseases of the joints: gout, psoriatic arthritis, osteoarthrosis (including post-traumatic), polyarthritis, scapulohumeral periarthritis, ankylosing spondylitis (Bechterew's disease), juvenile rheumatoid arthritis, syndrome Still in adults, bursitis, the non-tenosynovitis, synovitis and epicondylitis. Rheumatic fever, * acute rheumatic carditisBronchial asthma, asthma status. Acute and chronic allergic diseases: allergic reactions to DRUGS and food products, serum sickness, urticaria, allergic rhinitis, angioneuroticeski swelling, drug exanthema, hay fever. Diseases of the skin: pemphigus, psoriasis, eczema, atopic dermatitis, diffuse, atopic dermatitis, contact dermatitis (with the defeat of the large surface of the skin), drug reaction, seborrheic dermatitis exfoliativei dermatitis, toxic epidermal necrolysis (Laiella syndrome), bullous dermatitis herpetiformis, malignant exudative erythema (Stevens-Johnson syndrome). Edema of the brain (including in the face of brain tumor or associated with surgery, radiation therapy, or head injury) after pre-parenteral administration. Allergic eye diseases: allergic corneal ulcers, allergic forms of conjunctivitis. Inflammatory diseases of the eye: the sympathetic ophthalmic, heavy lingering front and rear uveitis, optic neuritis. Primary or secondary adrenal insufficiency (including condition after removal of the adrenal glands). Congenital adrenal hyperplasia. Kidney disease autoimmune genesis (incl. acute glomerulonephritis); argued syndrome. Subacute thyroiditis. Diseases of the organs of blood - agranulocytosis, panmielopatiya, autoimmune hemolytic anemia, acute lymphoid and myeloid leukemia, hodgkin's disease, thrombocytopenic purpura, secondary thrombocytopenia in adults, erythroblastopenia injectable (anemia), congenital (erythroid) hypoplastic anemia. Lung diseases: acute alveolitis, fibrosis of the lungs, sarcoidosis II-III century. Tuberculous meningitis, tuberculosis of the lungs, aspirate pneumonia (in conjunction with specific chemotherapy). Berylliosis, Leffler syndrome (not resistant to other therapy). Lung cancer (in combination with zitostatikami). Multiple sclerosis. DIGESTIVE diseases: ulcerative colitis, Crohn's disease, local enteritis. Hepatitis. Prevention of rejection reactions transplant. Gipercalziemia on the background of oncological diseases, nausea and vomiting associated with the conduct of cytostatic therapy. A disease mielomnaya.

Contraindications:
For short-term use for health reasons, the only contraindication is giperchuvstvitelnost.S caution. Parasitic and infectious diseases of viral, fungal or bacterial nature (currently or recently transferred, including the recent contact with sick), a simple herpes, herpes zoster (viremicheskaya phase), chickenpox, measles; amebiaz, strongyloidiasis (fixed or suspect); systemic mycosis, active and latent tb. Application in case of severe infectious diseases shall be admissible only on the background of specific therapy. Following immunization (period of 8 weeks before and two weeks after vaccination), lymphadenitis after BCG vaccination. Immunodeficiency states (incl. AIDS or HIV infection). GASTROINTESTINAL diseases, saying the disease stomach and duodenal ulcers, esophagitis, gastritis, acute or latent peptic ulcer, recently created anastomosis of the bowel, ulcerative colitis with the threat of perforation or abscess formation, diverticulitis. Diseases of the CCC, including recent myocardial infarction (in patients with acute and subacute myocardial infarction may spread of necrosis, slowing the formation of scar tissue and due to the rupture of the heart muscle), decompensated CHF, hypertension, hyperlipidemia). Endocrine diseases - diabetes mellitus (including infringement of tolerance to carbohydrates), thyrotoxicosis, hypothyroidism, a disease Itsenko-Kushinga. Severe chronic renal and / or hepatic impairment, nefrourolitiaz. Gipoalbuminemia, and conditions that predispose to its emergence. Systemic osteoporosis, and myasthenia gravis, acute psychosis, obesity (III-IV article.), Polio (except for the form bulbar encephalitis), an open-and closed-angle glaucoma, pregnancy, lactation period.

Side effects:
The frequency of the development and severity of side effects depend on the duration of use, amount used, the dose and the possibility of compliance with the circadian rhythm of destination. Endocrine system: reduced tolerance to glukoze, "steroid diabetes or a manifestation of latent diabetes mellitus, the oppression of the adrenal glands, the syndrome Itsenko-Kushinga (moon face, obesity pituitary type, hirsutism, increased AD, dysmenorrhea, amenorrhea, myasthenia gravis , austria), delayed sexual development in children. From the digestive system: nausea, vomiting, pancreatitis, "steroid" gastric ulcer and 12 duodenal ulcer, erosive esophagitis, bleeding and perforation of the GASTROINTESTINAL tract, increased or decreased appetite, flatulence, hiccups . In rare cases, increased activity of hepatic transaminases and alkaline phosphatase. By the CCC: arrhythmia, bradycardia (up to the stopping of the heart), development (in predisposed patients) or increased symptoms of CHF, ECG changes, characteristic for hypokalemia, increased AD