Triamcinolone hexacetonide

C12H22O, 38965-26-3) see Dexamethasone ten-butylacetate Triamcinolone hexacetonide tert-butyl acetoacetate... 

C24H3iFOft, 76-25-5) see Triamcinolone bcnctonide Triamcinolone hexacetonide triamcinolone cyclopentanonide (C2fiH33pOf, 55646-99-6) see Amcinonide... 

Systemic corticosteroids are a useful option in patients with contraindications to NSAIDs or colchicine (primarily renal impairment) or polyarticular attacks, especially in elderly patients. A single intramuscular injection of a long-acting corticosteroid such as triamcinolone hexacetonide may be used. Oral agents may be needed, especially for severe attacks. Prednisone 40 to 60 mg (or an equivalent dose of another agent) is given daily, with a gradual taper over 2 weeks. 

Intraarticular administration of triamcinolone hexacetonide 20 to 40 mg may be useful for acute gout limited to one or two joints. 

Intraarticular corticosteroid injections can provide relief, particularly when a joint effusion is present. Average doses for injection of large joints in adults are methylprednisolone acetate 20 to 40 mg or triamcinolone hexacetonide 10 to 20 mg. After aseptic aspiration of the effusion and corticosteroid injection, initial pain relief may occur within 24 to 72 hours, with peak relief occurring in about 1 week and lasting for 4 to 8 weeks. The patient should minimize joint activity and stress on the joint for several days after the injection. Therapy is generally limited to three or four injections per year because of the potential systemic effects of the drugs and because the need for more frequent injections indicates poor response to therapy. 

The IM route is preferable in nonadherent patients. Depot forms (triamcinolone acetonide, triamcinolone hexacetonide, methylprednisolone... 

Brand Name(s) (Triamcinolone hexacetonide) Aristospan Cfiemical Class Glucocorticoid, synthetic... 

Parenteral 3, 10, 40 mg/mL for IM, intra-articular, or intralesional injection Triamcinolone hexacetonide (Aristospan)... 

The limited penetration of topical corticosteroids can be overcome in certain clinical circumstances by the intralesional injection of relatively insoluble corticosteroids, eg, triamcinolone acetonide, triamcinolone diacetate, triamcinolone hexacetonide, and betamethasone acetate-phosphate. When these agents are injected into the lesion, measurable amounts remain in place and are gradually released for 3-4 weeks. This form of therapy is often effective for the lesions listed in Table 61-2 that are generally unresponsive to topical corticosteroids. The dosage of the triamcinolone salts should be limited to 1 mg per treatment site, ie, 0.1 mL of 10 mg/mL suspension, to decrease the incidence of local atrophy (see below). 

A 65-year-old man with bilateral osteoarthritis of the knees developed an effusion in the left knee. The swollen joint was treated with an intra-articular injection of triamcinolone hexacetonide 40 mg. The next day, he developed acute arthritis in the injected knee the joint was swollen and tender and he was unable to walk. Examination of the joint fluid showed 35 ml of a thick, turbid, yellowish synovial fluid with a leukocyte count of 13 x 106/1 (95% neutrophils). Gram and acridine orange stains were negative. Wet preparations of... 

The conclusive diagnosis in this case was triamcinolone hexacetonide crystal-induced arthropathy. 

Colfosceril palmitate Cortisone acetate Triamcinolone diacetate Triamcinolone hexacetonide Beractant... 

Oxytetracycline Dihydrate Triamcinolone Hexacetonide 604.3 Fazadinium Bromide... 

Triamcinolone hexacetonide Aristospan (Fujisawa) drug 20 polysorbate 80 (0.4%) benzyl alcohol (0.9%) sorbitol 295-296"" / 4.76 intralesional, intraarticular... 

Corticosteroids also may be delivered by injection. The intramuscular route is preferable in patients with compliance problems, since a depot effect is achieved. Depot forms of corticosteroids include triamcinolone acetonide, triamcinolone hexacetonide, and methylprednisolone acetate. This provides the patient with 2 to 8 weeks of symptomatic control. The depot effect provides a physiologic taper, avoiding withdrawal reaction associated with hypothalamic-pituitary axis suppression. It should be noted that the onset of effect via this route may be delayed by several days. Intravenous corticosteroids may be used to provide the patient with large amounts of drug during a steroid burst to control severe symptoms. Intra-articular injections of depot forms of corticosteroids can be useful in treating synovitis and pain when a small number of joints are affected. The onset and duration of symptomatic relief are similar to those of intramuscular injection. The intra-articular route often is preferred because it is associated with the fewest number of systemic adverse effects. If efficacious, intra-articular injections may be repeated every 3 months. No one joint should be injected more than two to three times per year because of the risk of accelerated joint destruction and atrophy of tendons. Soft tissues such as tendons and bursae also may be injected. This may help control the pain and inflammation associated... 

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