Names and pronunciation
(trye-am-sin′oh-lone) Kenalog, Kenalog-80, P-Care K40, P-Care K80, Pod-Care 100K, Pro- C-Dure 5, Pro-C-Dure 6, Zilretta
Source page 1331
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Individual generic drug information
Extracted information for triamcinolone only.
(trye-am-sin′oh-lone) Kenalog, Kenalog-80, P-Care K40, P-Care K80, Pod-Care 100K, Pro- C-Dure 5, Pro-C-Dure 6, Zilretta
Source page 1331
Func. class.: Corticosteroid, synthetic Func. class.: Corticosteroid, topical Func. class.: Topical anesthetic
Source pages 1331, 1333
Chem. class.: Glucocorticoid, intermediate acting Chem. class.: Synthetic fluorinated adrenal corticosteroid
Source pages 1331, 1333
ACTION: Decreases inflammation by suppression of migration of polymorpho- nuclear leukocytes, fibroblasts; reversal of increased capillary permeability and lysosomal stabilization T ACTION: Crosses cell membrane to attach to receptors to decrease inflammation, itching; inhibits multiple inflammatory cytokines ACTION: Binds with steroid receptors, decreases inflammation
Source pages 1331, 1333, 1334
USES: Severe inflammation, immuno- suppression, neoplasms, asthma (steroid dependent); collagen, respiratory, derma- tologic/rheumatic disorders USES: Inflammation/itching in corticosteroid-responsive dermatoses on the skin or inflammation in the mouth USES: Oral pain
Source pages 1331, 1333, 1334
Extracted information for triamcinolone only.
CONTRAINDICATIONS: Hyper- sensitivity, neonatal prematurity; epidural/ intrathecal administration (triamcinolone acetonide injections [Kenalog]), systemic fungal infections Precautions: Pregnancy, breastfeeding, diabetes mellitus, glaucoma, osteoporosis, seizure disorders, ulcerative colitis, HF, myasthenia gravis, renal disease, esophagitis, peptic ulcer, acne, cataracts, coagulopathy, head trauma, children <2 yr, psychosis, idio- pathic thrombocytopenia, acute glomerulo- nephritis, amebiasis, fungal infections, non- asthmatic bronchial disease, AIDS, TB, adrenal insufficiency, acute bronchospasm, acne rosacea, Cushing syndrome, acute MI, thromboembolism CONTRAINDICATIONS: Hyper- sensitivity, use on face or ear canal, infections Precautions: Pregnancy, breastfeeding, children CONTRAINDICATIONS: Hyper- sensitivity, application to large areas; presence of fungal, viral, or bacterial infections of mouth or throat Precautions: Pregnancy, children <6 yr, sepsis, denuded skin, geriatric patients
Source pages 1331, 1332, 1333, 1334
SIDE EFFECTS CNS: Depression, headache, mood changes CV: Hypertension, circulatory collapse, embolism, tachycardia, edema EENT: Fungal infections, increased intra- ocular pressure, blurred vision GI: Diarrhea, nausea, abdominal dis- tention, GI hemorrhage, increased appe- tite, pancreatitis HEMA: Thrombocytopenia INTEG: Acne, poor wound healing, ecchymosis, petechiae MS: Fractures, osteoporosis, weakness SIDE EFFECTS ENDO: HPA axis suppression, Cushing’s syndrome INTEG: Burning, folliculitis, pruritus, dermatitis, hypopigmentation META: Hyperglycemia; glycosuria SIDE EFFECTS INTEG: Rash, irritation, sensitization
Source pages 1332, 1333, 1334
INTERACTIONS Increase: side effects—alcohol, salicylates, indomethacin, amphotericin B, digoxin, cycloSPORINE, diuretics, quinolones Increase: action of triamcinolone— salicylates, estrogens, indomethacin, oral contraceptives, ketoconazole, macrolide antiinfectives, carBAMazepine Decrease: action of triamcinolone— cholestyramine, colestipol, barbiturates, rifAMPin, ePHEDrine, phenytoin, theophylline Decrease: effects of anticoagulants, anticonvulsants, antidiabetics, amben- onium, neostigmine, isoniazid, toxoids, vaccines, anticholinesterases, salicy- lates, somatrem Drug/Herb • Hypokalemia: aloe, cascara, senna Drug/Lab Test Increase: cholesterol, sodium, blood glu- cose, uric acid, calcium, urine glucose Decrease: calcium, potassium, T4, T3, thyroid 131I uptake test, urine 17-OHCS, 17-KS, PBI False negative: skin allergy tests INTERACTIONS Increase: blood glucose
Source pages 1332, 1333
Extracted information for triamcinolone only.
DOSAGE AND ROUTES • Adult: IM (acetonide) 40-80 mg q4wk; intraarticular (hexacetonide) 2-20 mg q3- 4wk • Child: IM acetonide 40 mg q4wk or 30-200 mcg/kg (1-6.25 mg/m2) q1- 7days (acetonide) 40-80 mg q4wk; in- traarticular (hexacetonide) 2-20 mg q3-4wk DOSAGE AND ROUTES • Apply to the affected areas bid-qid DOSAGE AND ROUTES • Adult: TOP Press 1/4 inch into affected area until film appears, repeat bid-tid
Source pages 1332, 1333, 1334
Available forms: Inj 3, 10, 40 mg/mL acetonide; inj 20, 5 mg/mL hexacetonide Available forms: Aerosol 0.2 mg; paste (dental) 0.1%; lotion, cream, ointment 0.025%; ointment 0.05%; lotion, cream, ointment 0.1%; ointment, cream 0.5% Available forms: Paste 0.1%
Source pages 1332, 1333, 1334
Administer: IM route • After shaking susp (parenteral) • Titrated dose; use lowest effective dose • IM inj deep in large muscle mass; rotate sites; avoid deltoid; use 21-G needle • Avoid SUBCUT administration, may damage tissue Administer: Topical route • May be used with occlusive dressings • Cream/ointment/lotion: apply spar- ingly in a thin film and rub gently into the cleansed, slightly moist affected area; may use gloves to apply cream/ointment/lotion • Paste: apply without rubbing, press into lesion until film develops • Spray: spray a small amount of prepa- ration onto the lesion Administer: • After cleansing oral cavity after meals
Source pages 1332, 1333, 1334
Extracted information for triamcinolone only.
Assess: • Potassium, blood glucose, urine glu- cose while patient receiving long-term therapy; hypokalemia and hyperglycemia • Weight daily; notify prescriber if weekly gain of >5 lb • B/P, pulse; notify prescriber if chest pain occurs • I&O ratio; be alert for decreasing uri- nary output, increasing edema • Plasma cortisol levels during long- term therapy (normal level: 138-635 nmol/L SI units when drawn at 8 AM) • Infection: increased temperature, WBC even after withdrawal of medica- tion; product masks infection • Potassium depletion: paresthesias, fa- tigue, nausea, vomiting, depression, polyuria, dysrhythmias, weakness • Edema, hypertension, cardiac symptoms • Mental status: affect, mood, behavioral changes, aggression • Assistance with ambulation for pa- tient with bone-tissue disease to prevent fractures • Beers: avoid in older adults with de- lirium or at high risk for delirium; moni- tor for confusion, delirium • Pregnancy/breastfeeding: use only if benefits outweigh fetal risk, cleft lip/palate has occurred (1st trimester); cautious use in breastfeeding, excreted in breast milk Assess: • Skin reactions: burning, pruritus, fol- liculitis, mouth lesions Assess: • Allergy: rash, irritation, reddening, swelling • Infection: if affected area is infected, do not apply
Source pages 1332, 1333, 1334
Evaluate: • Therapeutic response: ease of respira- tions, decreased inflammation Evaluate: • Decreasing itching, inflammation on the skin, decreasing mouth lesions Evaluate: • Therapeutic response: absence of pain in affected area
Source pages 1333, 1334
CLINICAL CONSIDERATIONS CLINICAL CONSIDERATIONS CLINICAL CONSIDERATIONS
Source pages 1332, 1333, 1334
Patient and caregiver information: • That emergency ID as corticosteroid user should be carried; not to discon- tinue abruptly, taper dose • To notify prescriber if therapeutic re- sponse decreases; that dosage adjust- ment may be needed • To avoid OTC products: salicylates, al- cohol in cough products, cold prepara- tions unless directed by prescriber; to avoid live vaccines • About cushingoid symptoms • About the symptoms of adrenal in- sufficiency: nausea, anorexia, fatigue, dizziness, dyspnea, weakness, joint pain See Appendix B (try-am-sin′oh-lone) Kenalog, Sila III, Trianex, Triderm Patient and caregiver information: T • How to use each product • That long-term use may cause thinning skin, loss of fat tissue; avoid long-term use (trye-am-sin′oh-lone) Kenalog in Orabase, Oralone Dental Patient and caregiver information: • To report rash, irritation, redness, swelling • How to apply paste
Source pages 1333, 1334
Extracted information for triamcinolone only.
PHARMACOKINETICS PO/IM: Peak 1-2 hr, half-life 2-5 hr PHARMACOKINETICS Absorption varies
Source pages 1332, 1333
Filter the extracted dose blocks for this individual drug.
• Child: IM acetonide 40 mg q4wk or 30-200 mcg/kg (1-6.25 mg/m2) q1- 7days (acetonide) 40-80 mg q4wk; in- traarticular (hexacetonide) 2-20 mg q3-4wk DOSAGE AND ROUTES
Candidate age grouping · source pages 1332, 1333, 1334