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GCS. Inhibits functions of leukocytes and tissue macrophages. Restricts migration of leukocytes to the area of inflammation. Disrupts the ability of macrophages to phagocytosis, as well as the formation of interleukin-1. Promotes stabilization of lysosomal membranes, thus reducing the concentration of proteolytic enzymes in the area of inflammation. Reduces capillary permeability, caused by the release of histamine. Suppresses fibroblast activity and collagen formation.
Inhibits the activity of phospholipase A2, which leads to suppression of the synthesis of prostaglandins and leukotrienes. Inhibits the release of COX (mainly COX-2), which also helps to reduce the production of prostaglandins.
Reduces the number of circulating lymphocytes (T- and B-cells), monocytes, eosinophils and basophils due to their movement from the vascular bed to the lymphoid tissue; inhibits antibody formation.
Aristocort (Triamcinolone) suppresses pituitary release of ACTH and β-lipotropin, but does not reduce circulating β-endorphin. It inhibits secretion of TSH and FSH.
It has a vasoconstrictor effect when directly applied to blood vessels.
Aristocort (Triamcinolone) has a pronounced dose-dependent effect on metabolism of carbohydrates, proteins and fats. It stimulates gluconeogenesis, promotes amino acid uptake by the liver and kidneys and increases the activity of gluconeogenesis enzymes. In the liver, triamcinolone increases glycogen deposition by stimulating glycogen synthetase activity and glucose synthesis from protein metabolism products. Increased blood glucose activates insulin release.
Aristocort (Triamcinolone) suppresses glucose uptake by fat cells, which leads to activation of lipolysis. However, due to increased insulin secretion, lipogenesis is stimulated, which contributes to fat accumulation.
It has a catabolic effect in the lymphoid and connective tissue, muscles, adipose tissue, skin, bone tissue.
Osteoporosis and Itzenko-Cushing's syndrome are the main factors limiting long-term GCS therapy. As a result of catabolic action, growth inhibition in children is possible.
At high doses, Aristocort (Triamcinolone) may increase brain tissue excitability and contribute to lowering the seizure threshold. It stimulates excessive production of hydrochloric acid and pepsin in the stomach, which contributes to the development of peptic ulcer.
When used systemically, the therapeutic activity of triamcinolone is due to anti-inflammatory, anti-allergic, immunosuppressive and antiproliferative effects.
When applied topically and externally, the therapeutic activity of triamcinolone is due to anti-inflammatory, anti-allergic and anti-exsudative (due to the vasoconstrictor effect).
When administered by inhalation, it has an anti-inflammatory effect on the bronchial mucosa in patients with bronchial asthma. With continued use, it reduces the number of mast cells, macrophages, T-lymphocytes and eosinophils in the epithelium and submucosa layer of the bronchi, suppresses airway hyperresponsiveness.
By anti-inflammatory activity, triamcinolone is close to hydrocortisone, and triamcinolone acetonide is 6 times more active. Mineralocorticoid activity in triamcinolone and triamcinolone acetonide is almost absent.
Contraindications to use
Acute psychosis in anamnesis, active tuberculosis, myasthenia, neoplasms with metastases, diverticulitis, peptic ulcer and duodenal ulcer, arterial hypertension, Icenko-Cushing's syndrome, renal failure, history of thrombosis and embolism, osteoporosis, diabetes mellitus, latent foci of infection, amyloidosis, syphilis, fungal diseases, viral infections (incl. Viral infections (including those caused by Herpes simplex and Varicella zoster), amebic infections, polio (except bulbar encephalitis), gonococcal or tuberculous arthritis, vaccination period, lymphadenitis after BCG vaccination, glaucoma, infected skin lesions.
Administration during pregnancy and lactation
If it is necessary to use during pregnancy (especially during the first trimester) and during lactation, the estimated benefit to the mother and the risk of side effects to the fetus or child should be assessed.
Not intended for intravenous administration.
Use with caution and under strict medical supervision in case of edema syndrome, obesity, mental diseases and gastrointestinal diseases. During treatment it is recommended to take vitamin D and consume foodstuffs rich in calcium.
After a single e/m injection of 60-100 mg in 24-48 hours, inhibition of adrenal function can be observed, which usually recovers within 30-40 days.
When used topically to prevent local infectious complications it is recommended to use in combination with antimicrobial agents.
Parenteral use in children under 6 years of age is not recommended; at 6-12 years of age - under strict indications.
Prolonged external use in children should be avoided regardless of age.
Indications of active substance Aristocort (Triamcinolone)
Oral administration: rheumatism, rheumatoid arthritis, systemic lupus erythematosus and other collagenoses, acute allergic reactions, allergic skin diseases, severe bronchial asthma, erythema multiforme, hemorrhagic diathesis, hemolytic anemia, lymphoma, leukemia.
For parenteral use: rheumatoid arthritis, connective tissue diseases, systemic lupus erythematosus, dermatoses, pulmonary emphysema and pulmonary fibrosis, lymphosarcoma, lymphogranulematosis, lymphatic leukemia, nephrotic syndrome, constipation.
For inhalation use: bronchial asthma in the acute phase. Insufficient effectiveness of bronchodilators and/or mast cell membrane stabilizers in the treatment of bronchial asthma. Hormone-dependent bronchial asthma (in order to reduce the dose of GCS for oral administration). Allergic rhinitis.
For external use: eczema, psoriasis, neurodermatitis, various types of dermatitis and other inflammatory and allergic skin diseases of non-microbial etiology (in combination therapy).
Orally in adults - 4-20 mg per day in 2-3 doses. After improvement of the condition, the daily dose is gradually reduced by 1-2 mg every 2-3 days to a minimum maintenance dose of 1 mg and complete withdrawal of therapy.
Per square meter at the beginning of treatment - 40 mg once every 4 weeks. Then, depending on the indications and the patient's response to treatment, 40-80 mg can be administered every 2-4 weeks. If necessary, the single dose can be increased to 100 mg. In order to avoid subcutaneous atrophy, it is injected deep into the muscle.
When administered intra-articularly, as well as when administered in the lesion area, the dose is 10-40 mg. The interval between injections is at least 1 week.
For inhalation use, the dose depends on the dosage form used and the age of the patient.
Outwardly it is used 1-3 times per day. Treatment duration is determined individually and is usually 5-10 days. If disease persists, treatment course may be prolonged up to 25 days. It is not recommended to use more than 4 weeks.