Triamcinolone nasal

Antihistamines are drags used to counteract the effects of histamine on body organs and structures. Examples of antihistamines include diphenhydramine (Benadryl), loratadine (Claritin), fexofenadine (Allegra), and cetirizine (Zyrtec). A new antihistamine, deslorata-dine (Clarinex), is die active metabolite of loratadine and is intended to eventually replace loratadine (Claritin). Topical corticosteroid nasal sprays such as fluticasone propionate (Flonase) or triamcinolone ace-tonide (Nasacort AQ) are also used for nasal allergy symptoms. See Chapter 56 for more information on die topical corticosteroids. 

Triamcinolone is a corticosteroid that is more potent than hydrocortisone and has a longer duration of action. Triamcinolone has only slight mineralocorticoid activity, whereas hydrocortisone has high mineralocorticoid activity and therefore triamcinolone is unsuitable for disease suppression on a long-term basis. Triamcinolone is available as injection, dental paste, nasal spray and as cream or ointment preparations. Hydrocortisone is available as cream, tablets and injections. 

Fluticasone Propionate Salmeterol Xinafoate (Advair Diskus, Advair HFA, 45/21, 115/21,230/21 Inhaled Aerosol) Ipratropium (Atrovent HFA, Atrovent Nasal) Nedocromil (Tilade) Tiotropium (Spiriva) Triamcinolone (Azmacort)... 

Beclomethasone dipropionate, triamcinolone acetonide, budesonide, flunisolide, and mometasone furoate are available as nasal sprays for the topical treatment of allergic rhinitis. They are effective at doses (one or two sprays one, two, or three times daily) that in most patients result in plasma levels that are too low to influence adrenal function or have any other systemic effects. 

Tri-Nasal spray is a metered-dose manual-spray pump in an amber polyethylene terephthalate bottle with 0.05% w/v triamcinolone acetonide in a solution containing citric acid, edetate disodium, polyethylene glycol 3350, propy-... 

Aqueous nasal triamcinolone spray 220 or 440 micrograms od for the treatment of allergic rhinitis reportedly had no measurable adverse effects on adrenocortical function in 80 children (aged 6-12 years) in a placebo-controlled, double-blind study (442). Plasma triamcinolone concentrations measured over 6 hours fell rapidly and there was little or no accumulation during 6 weeks. 

A 48-year-old man taking losartan, low-dose amitriptyline, and triamcinolone acetonide nasal spray developed pain in the abdomen and hips. Radiography and magnetic resonance imaging showed rapidly... 

Nayak AS, Ellis MH, Gross GN, Mendelson LM, Schenkel EJ, Lanier BQ, Simpson B, Mullin ME, Smith JA. The effects of triamcinolone acetonide aqueous nasal spray on adrenocortical function in children with allergic rhinitis. J Allergy Clin Immunol 1998 101(2 Part l) 157-62. 

Poon E, Fewings JM. Generalized eczematous reaction to budesonide in a nasal spray with cross-reactivity to triamcinolone. Australas J Dermatol 2001 42(l) 36-7. 

Carbomer is also compatible with dimethyl sulfoxide. The veterinary product, Domoso (Syntex Veterinary Labs), is a topical gel consisting of carbomer 934 and 90% dimethyl sulfoxide. Carbomer 940 gels exhibit superior optical clarity compared with 934 gels, and can be used in ophthalmic preparations. However, only carbomer 934 is approved for internal use. The mucoadhesive properties of carbomer were studied with triamcinolone acetonide, with acyclovir and to improve protein uptake across the nasal mucosa. Pharmaceutical gel products containing carbomer in their formulations are listed in Table 6. All are dermatological gels except for Anbesol Gel (Whitehall) and Pilopine HS (Alcon). 

PET techniques offer the important advantage in that the drug under study can be firmly labeled with the appropriate positron emitting isotope, usually nC or 1SF. Thus, deposition reflects the pharmaceutical itself, without interference from free isotope. Fluticasone dipropionate, triamcinolone acetonide, and zanamivir have all been labeled and their dose and distribution in the respiratory tract and/or the nasal cavity assessed with PET [48,50,123],... 

Nasal suspensions can be characterised by thixotropic properties [41]. Nasal sprays containing triamcinolone acetonide or mometasone furoate showed time-dependent, reversible loss of viscosity under shear (shaking or spraying,) flowing more freely. Recovery of viscosity after application is likely to inhibit suspension flowing out from the nasal cavity [42, 43]. 

Unilateral severe visual loss occurred in a 51-year-old woman after injection of triamcinolone acetonide into the nasal mucosa, resulting in permanent and severe visual disturbance with marked retinal atrophy [6 ]. 

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