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a synthetic corticosteroid (trade names Aristocort or Aristopak or Kenalog) used as an anti-inflammatory agent (同)Aristocort, Aristopak, Kenalog

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/02/25 17:38:02」(JST)

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Triamcinolone acetonide is a synthetic corticosteroid used to treat various skin conditions, and to relieve the discomfort of mouth sores.^[1] 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.^[2]

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.^[3]

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.^[4]

Medical use

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,^{[citation needed]}. 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.^[5] 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.

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).^{[citation needed]}

Evidence suggests that usage of traimcinolone acetonide or other steroids to treat macular edema increases the risk of increasing intraocular pressure in patients.^[6]

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.^{[citation needed]}

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.

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.^[7] A series of injections with triamcinolone acetonide or another corticosteroid may reduce keloid size and irritation. It is also used as a preinductor and/or inductor of birth in cows.

References

^ Triamcinolone Acetonide Drug information from MedLine Plus
^ Nasacort medication leaflet
^ "Kenalog injection," Web M.D.
^ Nasacort.com
^ "Nystatin And Triamcinolone (Topical Route)". mayoclinic.org. Mayo Foundation for Medical Education and Research. Retrieved 18 May 2016.
^ Gewaily D, Muthuswamy K, Greenberg PB (2015). "Intravitreal steroids versus observation for macular edema secondary to central retinal vein occlusion". Cochrane Database Syst Rev. 9 (9): CD007324. doi:10.1002/14651858.CD007324.pub3. PMC 4733851. PMID 26352007.
^ GENESIS® (triamcinolone acetonide) Topical Spray Drug information

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English Journal

Preclinical evaluation of thermoreversible triamcinolone acetonide hydrogels for drug delivery to the inner ear.

Engleder E1, Honeder C2, Klobasa J1, Wirth M1, Arnoldner C2, Gabor F3.
International journal of pharmaceutics.Int J Pharm.2014 Aug 25;471(1-2):297-302. doi: 10.1016/j.ijpharm.2014.05.057. Epub 2014 Jun 2.
Intratympanic glucocorticoid therapy aims to reduce the side effects associated with systemic long-time therapy of inner ear diseases or traumata after cochlear implantation. For that purpose, thermoreversible hydrogels being fluid at room temperature but solid at body temperature are known to be ap
PMID 24907595

Inhibitory effect of triamcinolone acetonide on synthesis of inflammatory mediators in the equine.

Mangal D1, Uboh CE2, Soma LR1, Liu Y1.
European journal of pharmacology.Eur J Pharmacol.2014 Aug 5;736:1-9. doi: 10.1016/j.ejphar.2014.04.013. Epub 2014 Apr 18.
Glucocorticoids (corticosteroids) are widely used anti-inflammatory agents in veterinary medical practice. These drugs are considered doping agents because they mask pain and thus, increase injury potential in equine athletes. They exhibit anti-inflammatory property by binding to glucocorticoids rec
PMID 24751711

Outcome of paediatric cataract surgery with primary posterior capsulotomy and anterior vitrectomy using intra-operative preservative-free triamcinolone acetonide.

Gupta R1, Ram J, Sukhija J, Singh R.
Acta ophthalmologica.Acta Ophthalmol.2014 Aug;92(5):e358-61. doi: 10.1111/aos.12375. Epub 2014 Apr 14.
PURPOSE: To evaluate the intra-operative and postoperative outcome of paediatric cataract surgery with primary posterior capsulotomy (PPC) and anterior vitrectomy using intra-operative preservative-free triamcinolone acetonide.METHODS: In this prospective, interventional case-control study, 20 Child
PMID 24730623

Japanese Journal

臨床報告 ASLOが高値を示した樹氷状血管炎の2症例に対するトリアムシノロンテノン下注射

山田教弘,板倉宏高,岸章治
眼科 54(9), 1221-1225, 2012-09
NAID 40019436833

特発性黄斑円孔に対する硝子体手術成績とトリアムシノロンアセトニドの効果 (特集第65回日本臨床眼科学会講演集(6))

金澤紘子,國方彦志,安田正幸 [他]
臨床眼科 66(8), 1219-1224, 2012-08
NAID 40019410925

「トリアムシノロン」

Triamcinolone acetonide
Names
	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
Identifiers
CAS Number	76-25-5
3D model (Jmol)	Interactive image
ChEBI	CHEBI:71418
ChEMBL	ChEMBL1504
ChemSpider	6196
ECHA InfoCard	100.000.863
IUPHAR/BPS	2867
PubChem	6436
UNII	F446C597KA
	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 Key: YNDXUCZADRHECN-JNQJZLCISA-N ; InChI=1/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 Key: YNDXUCZADRHECN-JNQJZLCIBL ;
	SMILES O=C\1\C=C5/[C@@](/C=C/1)(C)[C@]2(F)[C@H]([C@H]3[C@](C[C@@H]2O)([C@@]4(OC(O[C@@H]4C3)(C)C)C(=O)CO)C)CC5 ;
Properties
Chemical formula	C24H31FO6
Molar mass	434.50 g·mol−1
	Except where otherwise noted, data are given for materials in their standard state (at 25 °C [77 °F], 100 kPa).
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	Infobox references