In obstructive diseases of action lies principally in the airways, the inflammation inhibition, prevention or a decrease in the severity of mucosal edema, reduction of eosinophil infiltration submucosal bronchial epithelium layer and deposition in the bronchial mucosa of circulating immune complexes, as well as braking and erozirovaniya desquamation mucosa. It increases the sensitivity of the beta-adrenergic receptors of the bronchi of small and medium caliber to endogenous catecholamines and primobolan acetate exogenous sympathomimetic, reduces the viscosity of mucus by reducing its production.
It suppresses the synthesis and secretion of ACTH and secondary -. The synthesis of endogenous corticosteroids
Stops connective tissue reaction in the course of the inflammatory process and reduces the possibility of the formation of scar tissue.
For short-term use for health reasons only contraindication is hypersensitivity to triamcinolone, or components of the drug.
The children in the period of growth GCS should be applied only if absolutely indicated and under particularly close supervision of your doctor. Precautions :
- Diseases of the gastrointestinal tract – stomach ulcer and duodenal ulcer, esophagitis, gastritis, acute or latent peptic ulcer, recently established intestinal anastomosis, ulcerative colitis, with the threat of perforation or abscess, diverticulitis.
- parasitic and infectious diseases of viral, fungal or bacterial origin (occurring in currently or recently transferred, including the recent contact with the patient) – herpes simplex, herpes zoster (viremicheskaya phase), chicken pox, measles; amoebiasis, strongyloidiasis; systemic mycosis; active and latent tuberculosis. Application for serious infectious diseases is admissible only against the background of specific therapy.
- Pre – and post-vaccination period (8 weeks before and 2 weeks after vaccination), lymphadenitis after BCG vaccination.
- Immunodeficiency states (including AIDS or HIV infection).
- Diseases of the cardiovascular system, including recent myocardial infarction (in patients with acute and subacute myocardial infarction may spread necrosis, slowing the formation of scar tissue and, as a result, the heart muscle rupture), severe chronic heart failure, hypertension, hyperlipidemia.
- Endocrine diseases – diabetes mellitus (including breach of tolerance to carbohydrates), hyperthyroidism, hypothyroidism, Cushing’s disease, obesity (LLI-IV v).
- Severe chronic renal and / or hepatic insufficiency, nefrourolitiaz.
- Hypoalbuminemia and conditions predisposing to its FIRE.
- Systemic osteoporosis, myasthenia gravis, acute psychosis, polio (excluding the bulbar form of encephalitis), open-and-closure glaucoma.
- Pregnancy, lactation.
Use during pregnancy and lactation
During pregnancy (especially in 1 trimester) apply only for health reasons.
Since steroids penetrate into breast milk, if necessary, use during breast-feeding, breast-feeding is recommended to stop.
Dosing and Administration
Triamcinolone prescribed inside during or after eating. The initial dose is 4 -40 mg / day in 2 – 3 admission. Lymphoma and chronic leukemia, the initial dose is 75 mg / day. After improving the daily dose was gradually reduced to 1.2 mg every 2-3 days until a minimum maintenance dose or total cancellation.
Duration Triamcinolone application depends on the nature of the pathological process, and the effectiveness of treatment, ranging from several days to several months or more. Treatment primobolan acetate stopped gradually.
Children from 6 to 12 years with adrenal insufficiency – 0.117 mg / kg, once in the morning or in two divided doses, in other cases -. 0.416 – 1.7 mg / kg
Children weighing up to 25 kg – 0.1 – 0.5 mg / kg / day. In one or more steps. The maximum daily dose – 12-14 mg.
Side effects of
frequency and severity of side effects depend on the duration of application, size of the dosage used and the possibility of the circadian rhythm of destination Triamcinolone. From endocrine system : reduction of glucose tolerance, steroid diabetes or a manifestation of latent diabetes mellitus, adrenal suppression, Cushing’s syndrome (moon face, obesity, pituitary type, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, muscle weakness, striae) delayed sexual development in children. from the digestive system : nausea, vomiting, pancreatitis, steroid stomach ulcers and duodenal ulcers, erosive esophagitis , gastrointestinal bleeding and perforation of the wall of the gastrointestinal tract, increased or decreased appetite, indigestion, flatulence, hiccups. In rare cases, -increasing activity of “liver” transaminases and alkaline phosphatase. Cardio-vascular system : arrhythmia, bradycardia (up to cardiac arrest); development (in predisposed patients) or increased severity of heart failure, ECG – changes typical of hypokalemia, increased blood pressure, hypercoagulation, thrombosis. In patients with acute and subacute myocardial infarction – the spread necrosis, slowing the formation of scar tissue, which can lead to rupture of the heart muscle. From the nervous system : delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, pseudotumor cerebellum, headache, convulsions. from the sensory organs : posterior subcapsular cataracts, increased intraocular pressure with possible damage to the optic nerve, the propensity to develop secondary bacterial, fungal or viral eye infections trophic changes of the cornea, exophthalmos. On the part of metabolism : increased excretion of calcium, hypocalcemia, increased body weight, negative nitrogen balance (increased protein breakdown), increased sweating. Conditional mineralocorticoid activity : fluid retention and sodium in the body (peripheral edema), hypernatremia, hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue). from the musculoskeletal system : slowing growth and ossification processes in children (premature closure of epiphyseal growth zones), osteoporosis (very rare -patologicheskie fractures, aseptic necrosis of the humeral head and femur), tendon rupture of muscles, steroid myopathy, reduced muscle mass (atrophy). For the skin and mucous membranes : delayed wound healing, petechiae, ecchymosis, thinning of the skin, hyper- or hypopigmentation, acne, striae, the tendency to the development of pyoderma and candidiasis. Allergic reactions : skin rash, pruritus, anaphylactic shock. Other : development or exacerbation of infection (the appearance of this side effect contribute jointly used immunosuppressants and vaccination), leucocyturia, “cancellation” syndrome. Overdose Probably strengthening described side effects. In this primobolan acetate case, the dose should be reduced or temporarily suspend it. Treatment is symptomatic. migliori steroidi orali