Nasacort

トリアムシノロン

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/08/11 20:00:46」(JST)

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Triamcinolone acetonide

Clinical data
Routes of administration	Topical, joint injection
Identifiers
IUPAC name (4aS,4bR,5S,6aS,6bS,9aR,10aS,10bS)-4b-fluoro-6b-glycoloyl-5-hydroxy-4a,6a,8,8-tetramethyl-4a,4b,5,6,6a,6b,9a,10,10a,10b,11,12-dodecahydro-2H-naphtho[2',1':4,5]indeno[1,2-d][1,3]dioxol-2-one
Synonyms	9α-Fluoro-16α-17α-isopropyledenedioxyprednisolone; 9α-Fluoro-16α-hydroxyprednisolone 16α,17α-acetonide; 9α-Fluoro-11β,16α-17α,21-tetrahydroxypregna-1,4-diene-3,20-dione cyclic 16,17-acetal with acetone; 9α-Fluoro-11β,21-dihydroxy-16α,17α-isopropylidenedioxypregna-1,4-diene,3,20-dione
CAS Number	76-25-5 Y
PubChem CID	6436
IUPHAR/BPS	2867
ChemSpider	6196 Y
UNII	F446C597KA
ChEBI	CHEBI:71418 N
ChEMBL	CHEMBL1504 Y
ECHA InfoCard	100.000.863
Chemical and physical data
Formula	C24H31FO6
Molar mass	434.504 g/mol
3D model (JSmol)	Interactive image
SMILES C[C@]12C[C@@H]([C@]3([C@H]([C@@H]1C[C@@H]4[C@]2(OC(O4)(C)C)C(=O)CO)CCC5=CC(=O)C=C[C@@]53C)F)O
InChI InChI=1S/C24H31FO6/c1-20(2)30-19-10-16-15-6-5-13-9-14(27)7-8-21(13,3)23(15,25)17(28)11-22(16,4)24(19,31-20)18(29)12-26/h7-9,15-17,19,26,28H,5-6,10-12H2,1-4H3/t15-,16-,17-,19+,21-,22-,23-,24+/m0/s1 Y Key:YNDXUCZADRHECN-JNQJZLCISA-N Y
NY (what is this?)  (verify)

Triamcinolone acetonide is a synthetic corticosteroid used topically to treat various skin conditions, to relieve the discomfort of mouth sores and intra-articularly by proceduralists to treat various joint conditions. In nasal spray form, it is used to treat allergic rhinitis. It is a more potent derivative of triamcinolone, and is about eight times as potent as prednisone.

It is also known under the brand names Kenalog (topical) and Volon A as an injection, to treat allergies, arthritis, eye diseases, intestinal problems, and skin diseases. There are possible risks from an injection. It has been known to cause fat and muscle loss at an injection site, leaving a large divot bone deep.

In 2014, the FDA made triamcinolone acetonide an over-the-counter drug in the United States in nasal spray form under the brand name Nasacort.

Medical uses

Triamcinolone acetonide as an intra-articular injectable has been used to treat a variety of musculoskeletal conditions. When applied as a topical ointment, applied to the skin, it is used to mitigate blistering from poison ivy, oak, and sumac,. When combined with Nystatin, it is used to treat skin infections with and discomfort from fungus, though it should not be used on the eyes, mouth, or genital area. It provides relatively immediate relief and is used before using oral prednisone. Oral and dental paste preparations are used for treating aphthous ulcers.

As an intravitreal injection, triamcinolone acetonide has been used to treat various eye diseases and has been found useful in reducing macular edema. Drug trials have found it to be as efficient as anti-VEGF drugs in eyes with artificial lenses over a two-year period. A systematic review did not find any evidence of any benefit in preventing vision loss in eyes treated with triamcinolone acetonide over placebo, for patients with age-related macular degeneration.

Uncommonly, intramuscular injection of triamcinolone acetonide may be indicated for the control of severe or incapacitating allergic states for which conventional treatments have failed, such as asthma, atopic dermatitis, contact dermatitis, perennial or seasonal allergic rhinitis, serum sickness, and transfusion and drug hypersensitivity reactions.

Contraindications

As with all immunosuppressant drugs, triamcinolone acetonide should not be taken by persons suffering from infectious diseases, either currently or in recuperation or soon thereafter. Contact with infectious persons should be avoided during the entire course of treatment. Users who contract an infection during their regimen should contact their doctors to discuss whether to discontinue triamcinolone acetonide.

Triamcinolone acetonide should not be taken if the patient is also taking any other steroid or immunosuppressant, or if they have recently undergone any medical procedures involving the administration of steroids (e.g. nerve block).

Evidence suggests that usage of traimcinolone acetonide or other steroids to treat macular edema increases the risk of increasing intraocular pressure in patients.

Many drugs have been demonstrated to increase triamcinolone acetonide concentration in the blood to well above the intended level. Patients should inform doctors about any other drugs they are taking.

Triamcinolone acetonide should not be used by those with tuberculosis or untreated fungal, bacterial, systemic viral or herpes simplex infections without consulting a doctor first.

Chemistry

See also: List of corticosteroids

Triamcinolone acetonide, also known as 9α-fluoro-16α-hydroxyprednisolone 16α,17α-acetonide or as 9α-fluoro-11β,16α-17α,21-tetrahydroxypregna-1,4-diene-3,20-dione cyclic 16,17-acetal with acetone, is a synthetic halogenated cyclic ketal pregnane corticosteroid. It is the C16α,17α acetonide of triamcinolone.

Veterinary use

Triamcinolone acetonide is also used in veterinary medicine as an ingredient in topical ointments and in topical sprays for control of pruritus in dogs. A series of injections with triamcinolone acetonide or another corticosteroid may reduce keloid size and irritation. It is used as a preinductor and/or inductor of birth in cows. It is also used in the horse racing industry, it being a banned substance if found in a horse's system on race day.

See also

• Topical steroid relative strength groupings list

UpToDate Contents

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• 4. 成人における関節吸引または注射：手技および適応 joint aspiration or injection in adults technique and indications
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English Journal

• Comparison of the distribution of intranasal steroid spray using different application techniques.

• Tay SY1, Chao SS2, Mark KT2, Wang Y2.
• International forum of allergy & rhinology.Int Forum Allergy Rhinol.2016 Nov;6(11):1204-1210. doi: 10.1002/alr.21807. Epub 2016 Jun 17.
• BACKGROUND: Optimizing the intranasal distribution of nasal steroid spray (NS) is important in managing patients with allergic rhinitis (AR). Using a 3-dimensional computational model of the human nose, we found that inspiratory airflow improved particle distribution by 86%. We hence designed a stud
• PMID 27315490

• Rationally designed nanocarriers for intranasaltherapy of allergic rhinitis: influence of carrier type on in vivo nasal deposition.

• Sallam MA1, Helal HM1, Mortada SM1.
• International journal of nanomedicine.Int J Nanomedicine.2016 May 25;11:2345-57. doi: 10.2147/IJN.S98547. eCollection 2016.
• The aim of this study is to develop a locally acting nasal delivery system of triamcinolone acetonide (TA) for the maintenance therapy of allergic rhinitis. The effect of encapsulating TA in different nanocarriers on its mucosal permeation and retention as well as in vivo nasal deposition has been s
• PMID 27307734

• Comparison of the flow properties of aqueous suspension corticosteroid nasal sprays under differing sampling conditions.

• Sharpe SA1, Sandweiss V, Tuazon J, Giordano M, Witchey-Lakshmanan L, Hart J, Sequeira J.
• Drug development and industrial pharmacy.Drug Dev Ind Pharm.2003 Oct;29(9):1005-12.
• Many aqueous suspension corticosteroid nasal sprays become less viscous when shaken and sprayed, then return to a more viscous state after application. This time-dependent, reversible loss of viscosity under shear (e.g., shaking or spraying) can be quantified in the rheological property of thixotrop
• PMID 14606664

Related Links

• Over-the-Counter Nasal Allergy Spray | Nasacort®

You are about to leave the Nasacort.com Web site. Links to Web sites that are not under the control of Chattem are provided for convenience of reference only and are not intended as an endorsement by Chattem of the organization or ...

• Nasacort - FDA prescribing information, side effects and uses

Nasacort official prescribing information for healthcare professionals. Includes: indications, dosage, adverse reactions, pharmacology and more. ... Adverse events occurring at a rate of 3% or greater that were more common in the ...

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★リンクテーブル★

リンク元	「トリアムシノロン」
関連記事	「nasacort」

「トリアムシノロン」

　　[★]

英

triamcinolone Tr

ラ

triamcinolonum

同

フルオキシプレドニゾロン fluoxyprednisolone

化

トリアムシノロンアセトニド triamcinolone acetonide

商

ケナコルト、レダコート、マキュエイド、Nasacort

(口腔内用)アフタシール、アフタッチ、オルテクサー、トリシノロンゲル、トリシノロンクリーム、ワプロン、ケナログ、ノギロン

関

副腎ホルモン剤

• 糖質コルチコイド;中程度の抗炎症作用;外科用

「nasacort」

　　[★]

同

Nasacort

関

Triamcinolone acetonide