Triamcinolone Pharmacology

Triamcinolone

About Triamcinolone
A synthetic glucocorticoid, Antiasthmatic, anti-inflammatory.
Mechanism of Action of Triamcinolone
The drug exerts it`s pharmacological action by penetrating and binding to cytoplasmic receptor protein and causes a structural change in steroid receptor complex. This structural change allows it`s migration in to the nucleus and then binding to specific sites on the DNA which leads to transcription of specific m-RNA and which ultimately regulates protein synthesis. It exerts more selective glucocorticoid action. It stimulates the enzymes needed to decrease the inflammatory response.
The drug exerts anti-inflammatory and immunosuppressant actions as follows: - 1) Induce lipocortins in macrophages, endothelium, and fibroblasts which inhibits phospholipase A2 and thus decreases the production of Prostaglandins, leukotriens (LT), and platelet activating factor, 2) Causes negative regulation of genes for cytokines in macrophages, endothelial cells and lymphocytes and thus decreases the production of interleukins (IL-1, IL-2, IL-3, IL-6), TNF-a, GM-CSF (granulocyte macrophage colony stimulating factor), Gama interferon and suppresses fibroblast proliferation and T-lymphocyte functions and interferes chemo taxis. 3) Decreases the production of acute phase reactants from macrophages and endothelial cells and interferes complement function. 4) Decreases the production of ELAM-1(Endothelial leukocyte adhesion molecule-1) and ICAM-1(intracellular adhesion molecule-1) in endothelial cells. 5) Inhibit IgE mediated histamine and LT-C4 release from basophiles and the effects of antigen-antibody reaction is not mediated 6) Reduces the production of collagenase and stromolysin and thus prevents tissue destruction.
Pharmacokinets of Triamcinolone
Absorption: Well absorbed orally, Distribution: Distributed in to muscle, liver, kidney, skin, and intestine. It crosses the placenta and also secreted in breast milk, Metabolism: Metabolized in liver in to inactive metabolites by glucuronide and sulfate conjugation.
Excretion: Metabolites are excreted mainly through urine and a small amount is excreted through faeces.
Onset of Action for Triamcinolone
Rapid
Duration of Action for Triamcinolone
Up to 12 hours
Half Life of Triamcinolone
18 to 36 hours
Side Effects of Triamcinolone
1.Susceptibility to infection
2.Peptic ulcer
3.Haemorrhage
4.Glycosuria
5.Hyperglycaemia
6.Osteoporosis
7.Atrophy of adrenal cortex(on prolonged therapy)
8.Suppression of adrenocorticotropic hormone
9.Cushing`s syndrome
10.Inhibition of growth in children
11.Amenorrhoea
12.Behavioral disturbances
13.Thromboembolic disorders
14.Myopathy
15.Weakness
16.Lymphocytopenia
17.Muscle wasting
18.Gastrointestinal discomfort
19.Increased appetite
20.Delayed wound healing
21.Headache
22.Euphoria
23.Insomnia
24.Seizures
25.Heart failure
26.Arrhythmias
27.Posterior sub capsular cataract
28.Glaucoma
29.Sodium and fluid retention
30.Hypo kalaemia
31.Increased intracranial pressure
Contra-indications of Triamcinolone
1.Hypersensitivity to the drug
2.Epilepsy
3.Peptic ulcer
4.Tuberculosis
5.Systemic fungal infections
6.Herpes simplex
7.Renal impairment
8.Not to be given intravenously
Special Precautions while taking Triamcinolone
1.Avoid sudden discontinuation of the drug
2.Monitor vital parameters, therapeutic response and adjust the dosage
3.Use lower dosages as much as possible
4.Osteoporosis
5.Primary glaucoma
6.Primary psychosis and psychoneurosis
7.Recent myocardial infarction
8.Heart failure
9.Diabetes mellitus
10.Hypothyroidism
11.Cirrhosis
12.Stress
13.Sepsis
14.Hypertension
15.Myasthenia gravis
16.Hepatic impairment
17.Non specific Ulcerative colitis
18.Diverticulitis
19.Recent intestinal anastomosis
20.Seizures
21.Thromboembolic disorders
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
Neonates: Contraindicated

Indications for Triamcinolone
1.Allergic disorders
2.Asthma
3.Rheumatoid arthritis
4.Dermatoses
5.Adrenal insufficiency
6.Collagen diseases
7.Tuberculous meningitis
8.Respiratory diseases
9.Malignancies
10.Haematological disorders
11.Ophthalmic disorders
12.Severe inflammation
13.Oedematous states
14.Acute gout
Interactions for Triamcinolone
Barbiturates: Decreases efficacy of triamcinolone.
Oral contraceptives: May increase half life and concentration of triamcinolone.
Oestrogens: May decrease clearance of triamcinolone.
Rifampicin: Decreases efficacy.
Triamcinolone effects the action of the following:
Anticiholinesterases: Efficacy antagonised in myasthenia gravis.
Oral anticoagulants: Altered response.
Cyclosporine: Increased cyclosporine efficacy, toxicity may be enhanced.
Digitalis glycosides: Increased possibility of toxicity associated with hypokalaemia.
Isoniazid: Decreased serum levels of isoniazid.
Salicylates: Decreased serum levels of salicylates.
Diuretics: May cause increased hypokalaemia and increased hyperglycemia.
Non-depolarising muscle relaxants: Altered response.
Theophyllines: Altered response of either agent.
Lab Tests: Increases serum cholesterol levels. Increases urine glucose levels. Decreases Thyroid I uptake. Decreases T3 serum levels. Decreases serum potassium.
Typical Dosage for Triamcinolone
Oral: 4 to 32mg/day as once daily or 2 to 4 divided doses depending up on the severity of the condition.
Children: 4 to 12mg/day
Adrenal insufficiency: 4 to 12mg/day as once daily or as divided doses depending up on the severity of the condition.
Children: 117mcg/kg/day as once daily or as divided doses.
Collagen diseases, Tuberculous meningitis: 30 to 48mg/day.
Respiratory diseases: 16 to 48mg/day as once daily or as divided doses depending up on the severity of the condition.
Malignancies: 16 to 100mg/day as once daily or as divided doses depending up on the severity of the condition.
Parenteral: 4 to 32mg/day as once daily or as divided doses
I.M.: 40 to 60mg as deep I.M. injection depending up on the severity of the condition.
In asthma and hey fever increases the dosage up to 100mg as required by the patient.
Intra-articular: 2.5mg to 15mg depending up on the severity of the condition.
Intradermal: 0.2 to 0.3ml
Schedule of Triamcinolone
H
Storage Requirements for Triamcinolone
Store at room temperature in a well closed light resistant container. Protect from excess heat and moisture. Keep out of reach of children
Effects of Missed Dosage of Triamcinolone
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose

Effects of Overdose of Triamcinolone
Provide symptomatic treatment and supportive measures

Home Delivery for Triamcinolone in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including triamcinolone.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for triamcinolone and other medicines and health products. Home delivery services for triamcinolone may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take triamcinolone only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for triamcinolone before they complete the sale. You can get this information while placing the order for triamcinolone with the pharmacy.

Triamcinolone is a generic medicine name and there are several brands available for it. Some of the brands for triamcinolone might be better known than triamcinolone itself. If the pharmacy that's willing to deliver medicines to your home doesn't have triamcinolone in stock, you can ask for one of the branded alternatives for triamcinolone.