Trivaris

Lub npe dav: Triamcinolone acetonide
Dosage form: txhaj tshuaj
Chav kawm tshuaj: Ophthalmic steroids

Ntawm nplooj ntawv no

• Indications thiab siv
• Dosage thiab Administration
• Daim ntawv siv tshuaj thiab muaj zog
• Contraindications
• Ceeb toom thiab ceev faj
• Cov Kev Phem Tsis Zoo/Sib Phem
• Kev Sib Tham Tshuaj
• Siv nyob rau hauv cov neeg tshwj xeeb
• Kev noj ntau dhau
• Kev piav qhia
• Clinical Pharmacology
• Yuav Ua Li Cas Muab / Cia thiab tuav
• Cov Ntaub Ntawv Qhia Txog Tus Neeg Mob

Lub npe Trivaris tau raug txiav tawm hauv Teb Chaws Asmeskas Yog tias cov khoom lag luam ntawm cov khoom no tau pom zoo los ntawm FDA, tej zaum yuav muaj. generic equivalents muaj .

Cov lus qhia thiab kev siv rau Trivaris

Kev siv Ophthalmic

Trivaris ™(triamcinolone acetonide injectable suspension) 80 mg/mL yog qhia rau:

• sympathetic ophthalmia,
• temporal arteritis,
• uveitis, thiab
• Cov kab mob ocular inflammatory tsis teb rau cov tshuaj pleev corticosteroids.

Kev siv intramuscular

Yog qhov kev kho qhov ncauj tsis ua tau,Trivaris ™(triamcinolone acetonide injectable suspension) 80 mg/mL yog qhia rau kev siv intramuscular raws li hauv qab no:

Allergic xeev: Kev tswj xyuas qhov mob hnyav lossis tsis muaj peev xwm ua rau tsis haum rau kev sim ua kom txaus ntawm kev kho mob asthma, atopic dermatitis, tiv tauj dermatitis, tshuaj tiv thaiv tsis haum tshuaj, perennial lossis raws caij nyoog ua xua rhinitis, mob ntshav qab zib, kev hloov ntshav.

Cov kab mob dermatological:Bullous dermatitis herpetiformis, exfoliative erythroderma, mycosis fungoides, pemphigus, hnyav erythema multiforme (Stevens-Johnson syndrome).

Cov kab mob endocrine:Thawj lossis theem nrab adrenocortical insufficiency (hydrocortisone los yog cortisone yog cov tshuaj ntawm kev xaiv; synthetic analogs yuav siv tau nrog mineralocorticoids uas muaj feem xyuam; thaum yau, mineralocorticoid supplementation yog qhov tseem ceeb), congenital adrenal hyperplasia, hypercalcemia txuam nrog mob qog noj ntshav, nonsuppurative thyroiditis.

Cov kab mob hauv plab:Txhawm rau tide tus neeg mob dhau lub sijhawm tseem ceeb ntawm tus kab mob hauv cheeb tsam enteritis thiab ulcerative colitis.

Hematological kab mob:Tau txais (autoimmune) hemolytic anemia, Pob zeb diamond-Blackfan anemia, ntshiab liab cell aplasia, xaiv cov neeg mob thib ob ntawm thrombocytopenia.

Lwm yam:Trichinosis nrog neurologic los yog myocardial kev koom tes, tuberculous meningitis nrog subarachnoid block lossis impending block thaum siv nrog cov tshuaj tua kab mob tsim nyog.

Cov kab mob neoplastic: Rau kev tswj palliative ntawm leukemias thiab lymphomas.

Lub paj hlwb:Mob exacerbations ntawm ntau yam sclerosis; cerebral edema cuam tshuam nrog thawj lossis metastatic hlwb qog, craniotomy, lossis raug mob taub hau.

Kab mob raum: Txhawm rau ua kom diuresis lossis tshem tawm cov proteinuria hauv idiopathic nephrotic syndrome lossis vim lupus erythematosus.

Cov kab mob ua pa: Berylliosis, fulminating los yog disseminated pulmonary tuberculosis thaum siv concurrently nrog tsim nyog tshuaj tua kab mob antituberculous, idiopathic eosinophilic pneumonias, symptomatic sarcoidosis.

Cov kab mob Rheumatic:Raws li kev kho mob ntxiv rau kev tswj hwm lub sijhawm luv luv (kom tide tus neeg mob dhau qhov mob hnyav lossis exacerbation) hauv mob gouty mob caj dab; mob rheumatic carditis; ankylosing spondylitis; psoriatic mob caj dab; rheumatoid mob caj dab, nrog rau cov menyuam yaus rheumatoid mob caj dab (cov neeg raug xaiv yuav xav tau kev kho mob qis qis). Rau kev kho mob ntawm dermatomyositis, polymyositis, thiab kab mob lupus erythematosus.

Kev siv intra-articular

Intra-articular lossis mos cov ntaub so ntswg tswj ntawmTrivaris ™(triamcinolone acetonide injectable suspension) 80 mg/mL yog qhia raws li kev kho mob rau lub sij hawm luv luv (kom tide tus neeg mob dhau qhov mob los yog exacerbation) nyob rau hauv mob gouty mob caj dab, mob thiab subacute bursitis, mob nonspecific tenosyconditis, mob caj dab. , synovitis ntawm osteoarthritis.

Trivaris Dosage thiab Administration

Pom zoo noj

Thawj koob tshuaj ntawmTrivaris ™(triamcinolone acetonide injectable suspension) 80 mg/mL tej zaum yuav txawv ntawm 2.5 mg mus rau 100 mg ib hnub twg nyob ntawm seb tus kab mob twg raug kho (saibKEV PAB CUAM THIAB KEV PAB CUAM, 23 , 2.4 , 2.5 ). Txawm li cas los xij, hauv qee qhov xwm txheej hnyav, mob hnyav, ua rau muaj kev phom sij rau lub neej, kev noj tshuaj ntau dua li cov koob tshuaj ib txwm muaj yuav raug tsim nyog thiab tej zaum yuav muaj ntau ntawm qhov ncauj noj. Nws yuav tsum tau hais tias qhov kev xav tau ntau npaum li cas yog qhov sib txawv thiab yuav tsum yog tus kheej raws li tus kab mob hauv kev kho mob thiab cov lus teb ntawm tus neeg mob.

Tom qab cov lus teb zoo tau raug sau tseg, qhov kev saib xyuas kom zoo yuav tsum tau txiav txim siab los ntawm kev txo qis cov tshuaj thawj zaug hauv kev txo qis me me ntawm lub sijhawm tsim nyog kom txog rau thaum cov tshuaj qis tshaj plaws uas yuav tswj tau qhov chaw kho mob txaus. Cov xwm txheej uas tuaj yeem hloov kho qhov tsim nyog yog cov kev hloov pauv hauv qhov chaw kho mob thib ob rau kev tshem tawm lossis kev ua kom hnyav dua hauv cov txheej txheem kab mob, tus neeg mob tus neeg mob cov tshuaj tiv thaiv, thiab cov txiaj ntsig ntawm tus neeg mob raug rau cov xwm txheej ntxhov siab tsis ncaj qha ntsig txog tus kab mob hauv kev kho mob. Hauv qhov xwm txheej kawg no, nws yuav tsum tau nce qib ntawm cov tshuaj corticosteroid rau lub sijhawm raws li tus neeg mob tus mob. Yog tias tom qab kev kho mob mus ntev, cov tshuaj yuav tsum raug tso tseg, nws raug nquahu kom tshem tawm maj mam, tsis yog tam sim ntawd.

General Administration

Kev nruj aseptic yog yuav tsum tau.Cov txheej txheem ceev faj yuav tsum tau ua haujlwm kom tsis txhob muaj kev nkag mus rau hauv cov hlab ntsha los yog qhia txog kab mob.

Trivaris ™yuav tsum tau soj ntsuam pom qhov pom ntawm qhov teeb meem thiab discoloration ua ntej kev tswj hwm.

Ib txwm tso cai rau lub khob ntim dej ua ntej los zaum ntawm chav sov li 30 feeb ua ntej txheej txheem.

Kev siv tshuaj Intravitreal

Qhov pom zoo koob tshuaj intravitreal yog ib qho kev txhaj tshuaj ntawm 4 mg rau 0.05 mL (piv txwv li, 50 microliters ntawm 80 mg / mL raug tshem tawm).

Kev npaj rau kev txhaj tshuaj Intravitreal

Trivaris ™yog muaj yam tsis muaj koob txuas. Yog li ntawd, nws yog ib qho tsim nyog yuav tsum tau txuas ib rab koob xav tau rau lub syringe. A 27 gauge ½ nti koob yog qhia. Npaj lub ntim kom zoo ntawmTrivaris ™yuav tsum tau txhaj tshuaj los ntawm kev nce lub plunger mus rau ib kab uas cim rau ntawm lub khob ntim dej ua ntej ntim. Tuav lub koob txhaj tshuaj thiab rab koob ntawm lub kaum sab xis thiab nthuav tawm cov gel ncua kev kawm ntau dhau ntawm qhov chaw tsis muaj menyuam. Lub plunger raug muab tso rau kom raug thaum cov khoom siv dawb tsis pom ntawm lub plunger thiab cov kab sau ntawm lub koob txhaj tshuaj. Qhov no yuav muab cov koob tshuaj pom zoo ntawm 4 mg rau 0.05 mL. Nco ntsoov xyuas lub koob kom paub meej tias nws txuas nrog lub koob txhaj tshuaj ua ntej txhaj rau tus neeg mob.

Txoj kev txhaj tshuaj intravitreal yuav tsum tau ua raws li kev tswj hwm aseptic uas suav nrog kev siv cov hnab looj tes tsis muaj menyuam, cov ntaub qhwv tsis muaj menyuam, thiab daim tawv muag tsis muaj menyuam (lossis sib npaug). Kev siv tshuaj loog txaus thiab qhov dav-spectrum microbicide yuav tsum tau muab ua ntej txhaj tshuaj.

Tom qab txhaj tshuaj intravitreal, cov neeg mob yuav tsum tau saib xyuas kom nce siab hauv intraocular siab thiab endophthalmitis. Kev tshuaj xyuas yuav suav nrog kev kuaj xyuas rov qab ntawm lub paj hlwb ntawm lub taub hau tam sim tom qab txhaj tshuaj, tonometry hauv 30 feeb tom qab txhaj tshuaj, thiab biomicroscopy ntawm ob thiab xya hnub tom qab txhaj tshuaj. Cov neeg mob yuav tsum tau qhia kom tshaj tawm cov tsos mob qhia txog kev mob endophthalmitis yam tsis tau ncua.

Txhua syringe yuav tsum tsuas yog siv rau kev kho mob ntawm ib lub qhov muag xwb. Yog tias qhov muag tsis pom kev xav tau kev kho mob, yuav tsum tau siv lub koob txhaj tshuaj tshiab thiab qhov chaw tsis muaj menyuam, cov koob txhaj tshuaj, hnab looj tes, drapes, thiab daim tawv muag speculum thiab koob txhaj tshuaj yuav tsum tau hloov ua ntej.Trivaris ™yog muab rau lwm qhov muag.

Systemic Dosing

Thawj koob tshuaj tau pom zoo yog 60 mg,txhaj tob rau hauv cov leeg gluteal. Atrophy ntawm cov roj subcutaneous tuaj yeem tshwm sim yog tias qhov kev txhaj tshuaj tsis raug muab. Kev noj tshuaj feem ntau yog kho nyob rau hauv thaj tsam ntawm 40 txog 80 mg, nyob ntawm tus neeg mob cov lus teb thiab lub sijhawm ntawm kev nyem. Txawm li cas los xij, qee tus neeg mob tuaj yeem tswj tau zoo ntawm koob tshuaj tsawg li 20 mg lossis tsawg dua.

Rau cov neeg laus, qhov tsawg kawg nkaus koob ntev ntawm 1½ nti yog pom zoo. Hauv cov neeg mob rog rog, yuav tsum tau koob ntev dua. Siv lwm qhov chaw rau kev txhaj tshuaj tom ntej. Txhua syringe yuav tsum tsuas yog siv rau kev kho mob nkaus xwb. Kev txhaj tshuaj ntau zaus yuav tsum tau mus txog qhov koob tshuaj pom zoo.

Hauv cov neeg mob menyuam yaus, thawj koob tshuaj triamcinolone yuav txawv nyob ntawm seb tus kab mob twg raug kho. Qhov ntau ntawm thawj koob tshuaj yog 0.11 txog 1.6 mg / kg / hnub hauv peb lossis plaub zaug faib (3.2 txog 48 mg / mobbsa/hnub).

Rau lub hom phiaj ntawm kev sib piv, cov hauv qab no yog qhov sib npaug milligram ntau npaum li cas ntawm ntau yam glucocorticoids:

Cov kev sib raug zoo ntawm koob tshuaj no feem ntau siv rau qhov ncauj lossis kev tso ntshav ntawm cov tshuaj no. Thaum cov tshuaj no los yog lawv cov derivatives raug txhaj tshuaj intramuscularly lossis rau hauv qhov chaw sib koom ua ke, lawv cov khoom txheeb ze yuav hloov pauv zoo heev.

Hay fever lossis paj ntoos hawb pob: Cov neeg mob uas muaj hay fever lossis paj ntoos hawb pob uas tsis teb rau cov paj ntoos thiab lwm yam kev kho mob tuaj yeem tau txais kev tshem tawm cov tsos mob mus ntev thoob plaws lub caij paj ntoos tom qab txhaj tshuaj ib zaug ntawm 40 txog 100 mg.

Hauv kev kho mob hnyav ntawm ntau yam sclerosis, koob tshuaj txhua hnub ntawm 160 mg ntawm triamcinolone rau ib lub lis piam tom qab 64 mg txhua hnub rau ib hlis, raug pom zoo (saibCEEB TOOM THIAB KEV TIV THAIV, 5.12 ).

Intra-articular Dosing

Ib qho kev txhaj tshuaj hauv ib cheeb tsam ntawm triamcinolone acetonide feem ntau txaus, tab sis ntau qhov kev txhaj tshuaj yuav xav tau rau kev kho mob txaus.

Thawj koob tshuaj: 2.5 mus rau 5 mg rau cov pob qij txha me thiab los ntawm 5 mus rau 15 mg rau cov pob qij txha loj, nyob ntawm seb cov kab mob tshwj xeeb raug kho. Rau cov neeg laus, koob tshuaj txog li 10 mg rau thaj chaw me thiab txog li 40 mg rau thaj chaw loj feem ntau tau txaus. Kev txhaj tshuaj ib zaug rau hauv ob peb lub pob qij txha, txog li 80 mg, tau muab.

Rau kev kho cov pob qij txha, cov txheej txheem kev txhaj tshuaj ib txwm siv yuav tsum ua raws. Yog hais tias muaj ntau ntau ntawm cov kua synovial nyob rau hauv qhov sib koom ua ke, qee qhov, tab sis tsis yog tag nrho, yuav tsum tau txais kev pab los pab txo qhov mob thiab tiv thaiv kom tsis txhob muaj qhov tsis zoo ntawm cov tshuaj steroid. Txhua syringe yuav tsum tsuas yog siv rau kev kho mob nkaus xwb. Kev txhaj tshuaj ntau zaus yuav tsum tau ua kom ncav cuag cov koob tshuaj pom zoo.

Nrog rau kev tswj hwm intra-articular, ua ntej kev siv tshuaj loog hauv zos feem ntau yuav xav tau. Kev saib xyuas yuav tsum tau noj nrog hom kev txhaj tshuaj no, tshwj xeeb tshaj yog nyob rau hauv cheeb tsam deltoid, kom tsis txhob txhaj tshuaj gel rau hauv cov ntaub so ntswg nyob ib puag ncig ntawm qhov chaw, vim qhov no tuaj yeem ua rau cov ntaub so ntswg atrophy.

cov kev mob tshwm sim ntawm azo

Nyob rau hauv kev kho mob nonspecific tenosynovitis, yuav tsum tau saib xyuas kom ntseeg tau tias kev txhaj tshuaj ntawm corticosteroid yog tsim rau hauv cov leeg nqaij, tsis yog cov khoom siv leeg. Epicondylitis tuaj yeem kho tau los ntawm kev nkag mus rau qhov kev npaj rau hauv thaj tsam ntawm kev sib tw loj tshaj plaws.

Daim ntawv siv tshuaj thiab muaj zog

Ib zaug siv 0.1 mL syringe muaj 8 mg (80 mg / mL) ntawm triamcinolone acetonide ncua kev kawm ntawv.

Contraindications

Idiopathic Thrombocytopenic Purpura Cov

Intramuscular corticosteroid npaj yog contraindicated rau idiopathic thrombocytopenic purpura.

Cerebral Malaria

Corticosteroids yuav tsum tsis txhob siv rau hauv cerebral malaria.

Mob siab heev

Trivaris ™(triamcinolone acetonide injectable suspension) 80 mg/mL yog contraindicated nyob rau hauv cov neeg mob uas hypersensitive rau triamcinolone los yog tej yam khoom ntawm cov khoom no.

Ceeb toom thiab ceev faj

Tsis yog rau Intravenous Administration

VimTrivaris ™(triamcinolone acetonide injectable suspension) 80 mg/mL yog ncua kev kawm ntawv, nws yuav tsum tsis txhob muab tshuaj intravenously. Cov txheej txheem nruj aseptic yog qhov yuav tsum tau ua.

Kev hloov pauv hauv kev ua haujlwm endocrine

Hypothalamic-pituitary-adrenal (HPA) axis suppression, Cushing's syndrome, thiab hyperglycemia. Saib xyuas cov neeg mob rau cov mob no nrog kev siv ntev.

Corticosteroids tuaj yeem tsim kev thim rov qab HPA axis kev tawm tsam nrog lub peev xwm rau glucocorticosteroid tsis txaus tom qab tshem tawm kev kho mob. Tshuaj induced Secondary adrenocortical insufficiency tej zaum yuav raug txo los ntawm maj mam txo cov koob tshuaj. Hom kev txheeb ze tsis txaus no tuaj yeem tshwm sim rau lub hlis tom qab txiav kev kho mob; Yog li ntawd, nyob rau hauv txhua qhov teeb meem ntawm kev ntxhov siab tshwm sim thaum lub sijhawm ntawd, kev kho tshuaj hormone yuav tsum tau rov ua dua.

Txij li thaum mineralocorticoid secretion tej zaum yuav tsis ua hauj lwm, ntsev thiab / los yog ib tug mineralocorticoid yuav tsum tau noj ib txhij. Mineralocorticoid supplementation yog qhov tseem ceeb tshwj xeeb hauv cov menyuam mos.

Metabolic clearance ntawm corticosteroids txo qis hauv cov neeg mob hypothyroid thiab nce hauv cov neeg mob hyperthyroid. Kev hloov pauv hauv cov thyroid xwm txheej ntawm tus neeg mob yuav xav tau kev hloov pauv hauv cov tshuaj.

Muaj kev pheej hmoo ntxiv rau kev kis kab mob

• Corticosteroids tuaj yeem ua rau muaj kev pheej hmoo cuam tshuam txog kev kis tus kab mob, suav nrog kab mob, kab mob, fungal, protozoan, lossis kab mob helminthic. Cov qib uas koob tshuaj, txoj hauv kev thiab lub sijhawm ntawm kev tswj hwm corticosteroid cuam tshuam nrog cov kev pheej hmoo tshwj xeeb ntawm kev kis tus kab mob tsis zoo, txawm li cas los xij, nrog kev nce koob tshuaj corticosteroids, tus nqi ntawm qhov tshwm sim ntawm cov teeb meem sib kis tau nce.
• Corticosteroids tuaj yeem npog qee cov tsos mob ntawm tus kab mob thiab tuaj yeem txo qis kev tiv thaiv kab mob tshiab.
• Corticosteroids tuaj yeem ua rau kis kab mob ntau ntxiv thiab ua rau muaj kev pheej hmoo ntawm kev kis kab mob. Kev siv ntawmTrivaris ™nyob rau hauv active tuberculosis yuav tsum tau txwv rau cov mob ntawm fulminating los yog disseminated tuberculosis nyob rau hauv uas corticosteroid yog siv rau kev tswj tus kab mob nyob rau hauv nrog rau ib tug tsim nyog antituberculous regimen.
• Cov kab mob qhua pias thiab qhua pias tuaj yeem muaj qhov hnyav dua lossis ua rau tuag taus rau cov menyuam yaus uas tsis muaj kev tiv thaiv kab mob lossis cov neeg laus ntawm corticosteroids. Hauv cov menyuam yaus lossis cov neeg laus uas tsis muaj cov kab mob no, yuav tsum tau saib xyuas tshwj xeeb kom tsis txhob kis tau. Yog tias tus neeg mob kis tus kab mob qhua pias, prophylaxis nrog varicella zoster immune globulin (VZIG) yuav raug qhia. Yog hais tias tus neeg mob raug mob qhua pias, prophylaxis nrog pooled intramuscular immunoglobulin (IG) yuav raug qhia. Yog tias mob khaub thuas tshwm sim, kev kho mob nrog tshuaj tua kab mob yuav raug txiav txim siab.
• Corticosteroids yuav tsum tau siv nrog kev saib xyuas zoo hauv cov neeg mob uas paub lossis xav tias Strongyloides (threadworm) kab mob. Hauv cov neeg mob zoo li no, corticosteroid-induced immunosuppression tuaj yeem ua rau Strongyloides hyperinfection thiab kev nthuav tawm nrog kev txav mus los ntawm cov menyuam yaus, feem ntau nrog cov kab mob enterocolitis hnyav thiab ua rau tuag taus gram-negative septicemia.
• Corticosteroids tuaj yeem ua rau cov kab mob fungal ntau ntxiv thiab yog li yuav tsum tsis txhob siv thaum muaj cov kab mob no tshwj tsis yog lawv xav tau los tswj cov tshuaj tiv thaiv.
• Corticosteroids tuaj yeem ua rau muaj kev pheej hmoo ntawm kev rov ua haujlwm lossis ua rau muaj kab mob latent. Yog tias cov tshuaj corticosteroids tau qhia hauv cov neeg mob uas muaj tus kab mob latent tuberculosis lossis tuberculin reactivity, kev soj ntsuam ze yog qhov tsim nyog vim tias kev rov ua haujlwm ntawm tus kab mob yuav tshwm sim. Thaum lub sij hawm ntev kho corticosteroid, cov neeg mob yuav tsum tau txais chemoprophylaxis.
• Corticosteroids tuaj yeem ua rau latent amebiasis. Yog li ntawd, nws raug pom zoo kom txiav txim siab latent lossis nquag amebiasis ua ntej pib kho corticosteroid hauv txhua tus neeg mob uas tau siv sijhawm nyob rau hauv lub tropics lossis hauv ib tus neeg mob uas tsis tau piav qhia.

Cov teebmeem Ophthalmic

Kev siv cov tshuaj corticosteroids ntev ntev tuaj yeem tsim cov kab mob cataracts tom qab subcapsular, glaucoma nrog kev puas tsuaj rau cov hlab ntsha ntawm lub paj hlwb, thiab tuaj yeem txhim kho kev tsim cov kab mob thib ob vim yog cov kab mob fungi lossis kab mob.

Kev siv ntawm qhov ncauj corticosteroids tsis pom zoo rau kev kho mob ntawm optic neuritis thiab yuav ua rau muaj kev pheej hmoo ntawm cov mob tshiab.

Intraocular siab tej zaum yuav nce siab hauv qee tus neeg. Yog tias kev kho mob steroid txuas ntxiv rau ntau tshaj 6 lub lis piam, lub siab ntawm lub paj hlwb yuav tsum tau saib xyuas.

Corticosteroids yuav tsum tau siv ceev faj nyob rau hauv cov neeg mob uas muaj keeb kwm ntawm ocular herpes simplex vim muaj peev xwm ua rau pob txha perforation. Corticosteroidsyuav tsum tsis txhob siv nyob rau hauv activeocular herpes simplex.

Endophthalmitis

Tus nqi ntawm kab lis kev cai zoo endophthalmitis yog 0.5%. Cov txheej txheem aseptic tsim nyog yuav tsum tau siv tas li thaum tswj hwm triamcinolone acetonide.

Tsis tas li ntawd, cov neeg mob yuav tsum tau saib xyuas tom qab txhaj tshuaj kom tso cai kho thaum ntxov yog tias muaj kab mob tshwm sim.

Kev hloov pauv hauv Cardiovascular/Renal Function

Corticosteroids tuaj yeem ua rau nce ntshav siab, ntsev thiab dej tuav, thiab nce ntxiv ntawm cov poov tshuaj thiab calcium. Cov teebmeem no tsis tshua muaj tshwm sim nrog cov khoom siv hluavtaws tshwj tsis yog thaum siv cov koob tshuaj loj. Kev txwv tsis pub noj ntsev thiab cov poov tshuaj ntxiv yuav tsim nyog. Cov tshuaj no yuav tsum tau siv nrog ceev faj rau cov neeg mob ntshav siab, congestive plawv tsis ua hauj lwm, los yog lub raum insufficiency.

Cov ntaub ntawv tshaj tawm qhia txog kev sib koom ua ke ntawm kev siv corticosteroids thiab sab laug ventricular dawb phab ntsa tawg tom qab myocardial infarction tsis ntev los no; Yog li ntawd, kev kho mob nrog corticosteroids yuav tsum tau siv nrog ceev faj hauv cov neeg mob no.

Kev coj cwj pwm thiab kev xav tsis zoo

Kev siv corticosteroid tuaj yeem cuam tshuam nrog kev cuam tshuam hauv nruab nrab ntawm lub paj hlwb xws li euphoria, insomnia, mus ob peb vas hloov, hloov tus cwj pwm, thiab kev nyuaj siab loj, ua rau muaj kev puas siab puas ntsws. Tsis tas li ntawd, kev tsis txaus siab uas twb muaj lawm lossis kev xav puas siab puas ntsws tuaj yeem ua rau hnyav dua los ntawm corticosteroids.

Siv rau cov neeg mob uas muaj kab mob hauv plab

Muaj kev pheej hmoo siab ntawm plab hnyuv perforation hauv cov neeg mob uas muaj qee yam GI. Cov cim qhia ntawm GI perforation, xws li peritoneal irritation, tej zaum yuav npog rau cov neeg mob uas tau txais corticosteroids.

Corticosteroids yuav tsum tau siv nrog ceev faj yog tias muaj qhov tshwm sim ntawm qhov tshwm sim ntawm perforation, abscess lossis lwm yam kab mob pyogenic; diverticulitis; tshiab plab hnyuv anastomoses; thiab active los yog latent peptic rwj.

Txo cov pob txha ceev

Corticosteroids txo cov pob txha tsim thiab ua kom cov pob txha resorption ob leeg los ntawm lawv cov kev cuam tshuam ntawm calcium regulation (piv txwv li, txo kev nqus thiab nce excretion) thiab inhibition ntawm osteoblast muaj nuj nqi. Qhov no, ua ke nrog kev txo qis hauv cov protein matrix ntawm cov pob txha ob mus rau qhov nce hauv cov protein catabolism, thiab txo qis kev sib deev cov tshuaj hormones, tuaj yeem ua rau inhibition ntawm pob txha loj hlob hauv cov menyuam yaus thiab cov tub ntxhais hluas thiab kev loj hlob ntawm osteoporosis txhua hnub nyoog. Kev txiav txim siab tshwj xeeb yuav tsum tau muab rau cov neeg mob uas muaj kev pheej hmoo ntawm osteoporosis (piv txwv li, cov poj niam postmenopausal) ua ntej pib kho corticosteroid thiab pob txha ceev yuav tsum tau saib xyuas hauv cov neeg mob ntawm kev kho mob corticosteroid ntev.

Kev txhaj tshuaj

Kev tswj hwm ntawm kev ua neej nyob lossis nyob, cov tshuaj tiv thaiv qis yog contraindicated nyob rau hauv cov neeg mob tau txais kev txhaj tshuaj tiv thaiv kab mob corticosteroids. Cov tshuaj tiv thaiv raug tua lossis tsis ua haujlwm yuav raug muab tshuaj, txawm li cas los xij, cov lus teb rau cov tshuaj tiv thaiv tsis tuaj yeem kwv yees tau. Kev txhaj tshuaj tiv thaiv kab mob tuaj yeem ua rau cov neeg mob uas tau txais corticosteroids los hloov kho, piv txwv li, rau Addison tus kab mob.

Thaum kho corticosteroid, cov neeg mob yuav tsum tsis txhob txhaj tshuaj tiv thaiv kab mob. Lwm cov txheej txheem txhaj tshuaj yuav tsum tsis txhob ua rau cov neeg mob uas siv tshuaj corticosteroids, tshwj xeeb tshaj yog nyob rau hauv cov koob tshuaj ntau, vim muaj kev phom sij ntawm cov teeb meem hauv paj hlwb thiab tsis muaj cov tshuaj tiv thaiv kab mob.

Qhov cuam tshuam rau kev loj hlob thiab kev loj hlob

Kev siv cov tshuaj corticosteroids ntev ntev tuaj yeem cuam tshuam tsis zoo rau kev loj hlob thiab kev loj hlob ntawm cov menyuam yaus.

Kev loj hlob thiab kev loj hlob ntawm cov neeg mob menyuam yaus ntawm kev kho mob corticosteroid ntev yuav tsum tau ua tib zoo saib xyuas.

Siv thaum cev xeeb tub

Triamcinolone acetonide tuaj yeem ua rau tus menyuam raug mob thaum siv rau tus poj niam cev xeeb tub. Tib neeg thiab tsiaj cov kev tshawb fawb qhia tias kev siv corticosteroids thaum thawj peb lub hlis twg ntawm cev xeeb tub yog txuam nrog kev pheej hmoo ntawm orofacial clefts, intrauterine txoj kev loj hlob txwv thiab txo qhov hnyav thaum yug. Yog tias cov tshuaj no tau siv thaum cev xeeb tub, lossis yog tus neeg mob cev xeeb tub thaum siv cov tshuaj no, tus neeg mob yuav tsum tau pom tias muaj kev phom sij rau tus menyuam hauv plab. (saibSiv rau hauv cov neeg tshwj xeeb, 8.1 ).

Cov teebmeem Neuromuscular

Txawm hais tias kev tswj xyuas kev sim tshuaj tau pom tias corticosteroids ua tau zoo hauv kev daws teeb meem ntawm kev mob hnyav ntawm ntau yam sclerosis, lawv tsis qhia tias lawv cuam tshuam rau qhov kawg tshwm sim lossis keeb kwm ntawm tus kab mob. Cov kev tshawb fawb qhia tau hais tias cov koob tshuaj ntau ntawm corticosteroids yog qhov tsim nyog los ua kom pom muaj txiaj ntsig zoo. (saibKEV PAB CUAM THIAB KEV PAB CUAM, 2.4 ).

Ib qho mob myopathy tau pom nrog kev siv tshuaj ntau ntawm corticosteroids, feem ntau tshwm sim hauv cov neeg mob uas muaj kev cuam tshuam ntawm kev sib kis ntawm neuromuscular (piv txwv li, myasthenia gravis), lossis hauv cov neeg mob tau txais kev kho nrog cov tshuaj tiv thaiv neuromuscular (piv txwv li, pancuronium). Qhov mob myopathy no yog dav dav, tuaj yeem koom nrog cov leeg nqaij thiab ua pa, thiab tuaj yeem ua rau quadriparesis. Qhov siab ntawm creatine kinase tuaj yeem tshwm sim. Kev txhim kho kho mob lossis rov zoo tom qab tso tseg corticosteroids yuav xav tau ntau lub lis piam mus rau xyoo.

Kaposi's Sarcoma

Kaposi's sarcoma tau tshaj tawm tias tshwm sim hauv cov neeg mob tau txais kev kho corticosteroid, feem ntau yog rau cov mob ntev. Kev txiav tawm ntawm corticosteroids tuaj yeem ua rau kev txhim kho kev kho mob.

Intra-articular thiab Soft Tissue Administration

Intra-articularly txhaj tshuaj corticosteroids tuaj yeem nqus tau.

Kev ntsuam xyuas tsim nyog ntawm cov kua dej sib koom ua ke yog qhov tsim nyog kom tshem tawm cov txheej txheem septic.

Ib qho kev mob tshwm sim ntxiv nrog rau qhov o hauv zos, kev txwv ntxiv ntawm kev sib koom ua ke, ua npaws, thiab malaise yog qhia txog kev mob caj dab septic. Yog tias qhov teeb meem no tshwm sim thiab qhov kev kuaj mob ntawm sepsis tau lees paub, kev kho mob antimicrobial tsim nyog yuav tsum tau tsim.

Kev txhaj tshuaj steroid rau hauv qhov chaw muaj kab mob yuav tsum zam. Kev txhaj tshuaj hauv zos ntawm steroid rau hauv kev sib koom ua ke yav dhau los tsis pom zoo.

Kev txhaj tshuaj corticosteroid rau hauv cov pob qij txha tsis ruaj khov feem ntau tsis pom zoo.

Kev txhaj tshuaj intra-articular yuav ua rau muaj kev puas tsuaj rau cov ntaub so ntswg (saibTXOJ CAI TSHIAB, 6.8 ).

Kev Phem Tsis Zoo

(sau npe alphabetically hauv qab txhua ntu)

Cov kev tsis zoo hauv qab no tuaj yeem cuam tshuam nrog kev kho corticosteroid:

Kev ua xua

Cov tshuaj tiv thaiv anaphylactoid, anaphylaxis, angioedema.

Mob plawv

Bradycardia, plawv nres, plawv arrhythmias, mob plawv, circulatory collapse, congestive plawv tsis ua hauj lwm, rog embolism, kub siab, hypertrophic cardiomyopathy nyob rau hauv cov me nyuam mos ntxov ntxov, myocardial rupture tom qab tsis ntev los no myocardial infarction (saibCEEB TOOM THIAB KEV TIV THAIV, 5.5 ), pulmonary edema, syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis.

Dermatology

Pob txuv, ua xua dermatitis, cutaneous thiab subcutaneous atrophy, qhuav scaly ntawm daim tawv nqaij, ecchymoses thiab petechiae, edema, erythema, hyperpigmentation, hypopigmentation, impaired qhov txhab zoo, nce tawm hws, lupus erythematosus zoo li cov kab mob, purpura, ua pob liab vog, sterile rhiab heev. rau kev ntsuam xyuas ntawm daim tawv nqaij, daim tawv nqaij nyias nyias, tawv tawv nqaij tawv nqaij, urticaria.

Endocrine

Txo cov carbohydrate thiab qabzib kam rau ua, kev loj hlob ntawm cushingoid xeev, glycosuria, hirsutism, hypertrichosis, nce kev xav tau rau insulin lossis qhov ncauj hypoglycemic cov neeg ua haujlwm hauv ntshav qab zib, tshwm sim ntawm latent ntshav qab zib mellitus, kev coj khaub ncaws tsis xwm yeem, theem nrab adrenocortical thiab pituitary insponsiveness, nyob rau hauv kev raug mob, phais, los yog mob), tsub kom kev loj hlob ntawm cov me nyuam cov neeg mob.

Dej thiab Electrolyte cuam tshuam

Congestive plawv tsis ua hauj lwm nyob rau hauv cov neeg mob uas raug mob, tso kua dej, hypokalemic alkalosis, poov tshuaj poob, sodium retention.

plab hnyuv

Mob plab, plab hnyuv / zais zis tsis ua haujlwm (tom qab kev tswj hwm intrathecal), nce siab hauv cov ntshav siab enzyme (feem ntau thim rov qab thaum tsis txuas ntxiv), hepatomegaly, nce qab los noj mov, xeev siab, mob pancreatitis, peptic rwj nrog perforation thiab hemorrhage, perforation ntawm cov me thiab loj intestine. (tshwj xeeb tshaj yog nyob rau hauv cov neeg mob inflammatory plob tsis so tswj kab mob), ulcerative esophagitis.

Metabolic

Tsis zoo nitrogen tshuav vim protein catabolism.

Musculoskeletal

Aseptic necrosis ntawm femoral thiab humeral hau, calcinosis (raws li kev siv intra-articular lossis intralesional), Charcot-zoo li arthropathy, poob ntawm cov leeg nqaij, leeg tsis muaj zog, osteoporosis, pathologic tawg ntawm cov pob txha ntev, tom qab txhaj tshuaj flare (raws li kev siv intra-articular) steroid myopathy, tendon rupture, vertebral compression fractures.

Neurological / Psychiatric

Convulsions, kev nyuaj siab, kev xav tsis meej pem, euphoria, mob taub hau, nce intracranial siab nrog papilledema (pseudotumor cerebri) feem ntau tom qab discontinuation ntawm kev kho mob, insomnia, mus ob peb vas swings, neuritis, neuropathy, paresthesia, cwm pwm hloov, psychic ntshawv siab, vertigo. Arachnoiditis, meningitis, paraparesis / paraplegia, thiab kev puas siab puas ntsws tau tshwm sim tom qab kev tswj hwm intrathecal

Ophthalmic

Kev hnov ​​​​mob hauv qhov muag, anterior chamber cells, anterior chamber flare, cataract, cataract cortical, cataract nuclear, cataract subcapsular, conjunctival haemorrhage, exophthalmos, qhov muag irritation, qhov muag mob, qhov muag pruritus, txawv teb chaws lub cev hnov ​​nyob rau hauv lub qhov muag, glaucoma, nce siab, Qhov chaw txhaj tshuaj haemorrhage, lacrimation nce, vitreous detachment, vitreous floaters thiab tsawg zaus ntawm qhov muag tsis pom kev cuam tshuam nrog intravitreal lossis periocular txhaj.

Lwm yam

Cov rog tsis txawv txav, txo qis kev tiv thaiv kab mob, hiccups, nce lossis txo qis zog thiab cov spermatozoa, malaise, lub ntsej muag lub hli, qhov hnyav nce.

Kev Sib Tham Tshuaj

Aminoglutethimide

Aminoglutethimide tuaj yeem ua rau poob ntawm corticosteroid-induced adrenal suppression.

Amphotericin B Injection thiab Potassium-depleting Agents

Thaum noj corticosteroids ua ke nrog cov tshuaj potassium-depleting (piv txwv li, amphotericin B, diuretics), cov neeg mob yuav tsum tau saib xyuas kom zoo rau kev txhim kho hypokalemia. Muaj cov ntaub ntawv qhia nyob rau hauv uas concomitant siv amphotericin B thiab hydrocortisone tau ua raws li lub plawv o thiab congestive plawv tsis ua hauj lwm.

Tshuaj tua kab mob

Macrolide tshuaj tua kab mob tau raug tshaj tawm tias ua rau txo qis hauv corticosteroid clearance.

Anticholinesterases

Kev siv cov tshuaj anticholinesterase thiab corticosteroids sib xyaw ua ke tuaj yeem ua rau tsis muaj zog hauv cov neeg mob myasthenia gravis. Yog tias ua tau, cov tshuaj anticholinesterase yuav tsum raug tshem tawm tsawg kawg 24 teev ua ntej pib kho corticosteroid.

Anticoagulants, Qhov ncauj

Kev sib koom ua ke ntawm corticosteroids thiab warfarin feem ntau ua rau inhibition ntawm cov lus teb rau warfarin, txawm hais tias muaj qee cov lus ceeb toom tsis sib haum. Yog li, coagulation indices yuav tsum tau saib xyuas ntau zaus kom tswj tau cov nyhuv anticoagulant xav tau.

Antidiabetics

Vim tias corticosteroids tuaj yeem ua rau cov ntshav qabzib ntau ntxiv, kev hloov kho cov tshuaj tiv thaiv kab mob yuav tsum tau ua.

Tshuaj Antitubercular

Cov concentration ntawm isoniazid tuaj yeem txo qis.

Cholestyramine

Cholestyramine tuaj yeem ua rau kom tshem tawm ntawm corticosteroids.

Cyclosporine

Kev ua kom muaj zog ntawm ob qho tib si cyclosporine thiab corticosteroids tuaj yeem tshwm sim thaum siv ob qho tib si. Convulsions tau tshaj tawm nrog qhov kev siv tam sim no.

Digitalis Glycosides

Cov neeg mob ntawm digitalis glycosides tuaj yeem muaj kev pheej hmoo siab ntawm arrhythmias vim hypokalemia.

Estrogens, nrog rau cov tshuaj tiv thaiv qhov ncauj

Cov tshuaj estrogens tuaj yeem txo qis cov metabolism hauv siab ntawm qee yam corticosteroids, yog li ua rau lawv cov nyhuv.

Hepatic Enzyme Inducers (piv txwv li, barbiturates, phenytoin, carbamazepine, thiab rifampin)

Cov tshuaj uas ua rau cov tshuaj hepatic microsomal tshuaj metabolizing enzyme kev ua haujlwm tuaj yeem txhim kho cov metabolism ntawm corticosteroids thiab xav kom cov tshuaj corticosteroid ntau ntxiv.

Ketoconazole

Ketoconazole tau tshaj tawm tias yuav txo qis cov metabolism ntawm qee yam corticosteroids txog li 60%, ua rau muaj kev pheej hmoo ntawm corticosteroid ntau ntxiv.

Nonsteroidal Anti-inflammatory Agents (NSAIDs)

Kev siv cov tshuaj aspirin (lossis lwm cov tshuaj uas tsis yog tshuaj tiv thaiv kab mob) thiab corticosteroids ua rau muaj kev pheej hmoo ntawm kev mob plab hnyuv. Aspirin yuav tsum tau siv ceev faj ua ke nrog corticosteroids hauv hypoprothrombinemia. Kev tshem tawm ntawm salicylates tuaj yeem nce ntxiv nrog kev siv cov tshuaj corticosteroids.

Kev kuaj tawv nqaij

Corticosteroids tuaj yeem tiv thaiv kev ua xua rau ntawm daim tawv nqaij.

Cov tshuaj tiv thaiv kab mob

Cov neeg mob ntawm kev kho corticosteroid ntev ntev tuaj yeem pom qhov txo qis rau cov tshuaj toxoids thiab cov tshuaj tiv thaiv nyob lossis tsis muaj zog vim yog inhibition ntawm cov tshuaj tiv thaiv kab mob. Corticosteroids kuj tseem tuaj yeem ua rau muaj kev rov ua dua ntawm qee yam kab mob uas muaj nyob hauv cov tshuaj tiv thaiv nyob. Kev tswj hwm niaj hnub ntawm cov tshuaj tiv thaiv lossis cov tshuaj toxoids yuav tsum tau ncua kom txog thaum kev kho corticosteroid raug txiav tawm yog tias ua tau (saibCEEB TOOM THIAB KEV TIV THAIV, 5.9 ).

Siv rau hauv cov neeg tshwj xeeb

Kev xeeb tub

Cev xeeb tub Qeb D (saibCEEB TOOM THIAB KEV TIV THAIV, 5.11 ).

Cov teebmeem teratogenic: Ntau pawg thiab cov ntaub ntawv tswj xyuas hauv tib neeg tau hais tias kev siv corticosteroid niam txiv thaum lub sijhawm thawj peb lub hlis twg ua rau nce tus nqi ntawm daim di ncauj nrog lossis tsis muaj cleft palate los ntawm kwv yees li 1/1000 tus menyuam mos mus rau 3 - 5/1000 tus menyuam mos. Ob txoj kev tshawb fawb txog kev tswj xyuas qhov tshwm sim tau pom tias qhov kev yug me nyuam poob qis hauv cov me nyuam mos raug rau niam txiv corticosteroids hauv utero.

Triamcinolone acetonide yog teratogenic nyob rau hauv nas, luav, thiab liab. Hauv nas thiab luav, triamcinolone acetonide yog teratogenic ntawm qhov nqus nqus ntawm 0.02 mg / kg thiab siab dua thiab hauv cov liab, triamcinolone acetonide yog teratogenic ntawm qhov nqus nqus ntawm 0.5 mg / kg. Kev noj tshuaj teratogenic cuam tshuam hauv nas thiab luav suav nrog cleft palate thiab / lossis sab hauv hydrocephaly thiab axial skeletal defects, whereas cov teebmeem tshwm sim hauv cov liab yog cranial malformations. Cov teebmeem no zoo ib yam li cov uas tau sau tseg nrog lwm cov tshuaj corticosteroids.

Corticosteroids yuav tsum tau siv thaum cev xeeb tub nkaus xwb yog tias cov txiaj ntsig muaj peev xwm ua rau muaj kev pheej hmoo rau tus menyuam hauv plab. Cov menyuam mos yug los rau cov niam uas tau txais corticosteroids thaum cev xeeb tub yuav tsum tau ua tib zoo saib xyuas cov tsos mob ntawm hypoadrenalism.

Niam laus

Corticosteroids secreted hauv tib neeg cov kua mis. Cov ntawv ceeb toom qhia tias cov tshuaj steroid ntau hauv tib neeg cov kua mis yog 5 mus rau 25% ntawm niam txiv cov ntshav, thiab tag nrho cov me nyuam mos noj txhua hnub yog me me, tsawg dua 0.2% ntawm niam txiv noj txhua hnub. Qhov kev pheej hmoo ntawm tus me nyuam raug rau cov tshuaj steroids los ntawm cov kua mis yuav tsum tau hnyav rau cov txiaj ntsig paub txog kev pub niam mis rau leej niam thiab tus menyuam.

Kev siv menyuam yaus

Kev ua tau zoo thiab kev nyab xeeb ntawm cov tshuaj corticosteroids hauv cov menyuam yaus yog nyob ntawm kev tsim kom muaj txiaj ntsig zoo ntawm cov tshuaj corticosteroids uas zoo sib xws hauv cov menyuam yaus thiab cov neeg laus.

Cov teebmeem tsis zoo ntawm corticosteroids hauv cov neeg mob menyuam yaus zoo ib yam li cov neeg laus (saibTXOJ CAI TSHIAB, 6 ).

Ib yam li cov neeg laus, cov neeg mob menyuam yaus yuav tsum tau ua tib zoo saib xyuas nrog kev ntsuas ntshav siab, qhov hnyav, qhov siab, qhov siab ntawm lub cev, thiab kev soj ntsuam kev soj ntsuam rau qhov muaj kab mob, kev puas siab puas ntsws, thromboembolism, peptic ulcers, cataracts, thiab osteoporosis. Cov menyuam yaus, uas tau kho nrog corticosteroids los ntawm txhua txoj hauv kev, suav nrog kev tswj hwm cov tshuaj corticosteroids, tej zaum yuav muaj kev poob qis hauv lawv qhov kev loj hlob sai. Qhov kev cuam tshuam tsis zoo ntawm corticosteroids ntawm kev loj hlob tau pom nyob rau hauv cov koob tshuaj qis thiab tsis muaj cov pov thawj hauv chaw kuaj mob ntawm HPA axis suppression (piv txwv li, cosyntropin stimulation thiab basal cortisol plasma qib). Kev loj hlob tshaj tawm tuaj yeem yog qhov qhia tau ntau dua ntawm cov kab mob corticosteroid raug rau cov menyuam yaus dua li qee qhov kev sim siv HPA axis muaj nuj nqi. Txoj kev loj hlob ntawm cov menyuam yaus kho nrog corticosteroids los ntawm txhua txoj hauv kev yuav tsum tau saib xyuas, thiab qhov muaj peev xwm loj hlob ntawm kev kho mob ntev yuav tsum tau hnyav rau cov txiaj ntsig kho mob tau txais thiab muaj lwm txoj kev kho mob. Txhawm rau txo qis qhov muaj peev xwm loj hlob ntawm corticosteroids, cov menyuam yaus yuav tsum tau titrated rau qhov qis tshaj plaws.

Kev siv Geriatric

Qhov tshwm sim ntawm corticosteroid-vim cov kev mob tshwm sim tuaj yeem nce ntxiv hauv cov neeg mob laus thiab muaj feem cuam tshuam txog koob tshuaj. Osteoporosis yog qhov teeb meem feem ntau ntsib, uas tshwm sim ntawm qhov tshwm sim ntau dua hauv cov neeg mob corticosteroid-kho geriatric piv rau cov neeg hluas thiab hauv cov hnub nyoog sib xws. Kev poob ntawm cov pob txha pob txha pob txha zoo li zoo tshaj plaws thaum ntxov ntawm kev kho mob thiab tuaj yeem rov qab tau lub sijhawm tom qab tshem tawm cov tshuaj steroid lossis siv cov tshuaj qis dua.

Kev noj ntau dhau

Kev kho mob ntau dhau yog los ntawm kev txhawb nqa thiab kho cov tsos mob. Rau kev noj tshuaj ntau dhau rau lub ntsej muag ntawm cov kab mob hnyav uas xav tau kev kho mob steroid tas li, cov tshuaj corticosteroid yuav raug txo qis ib ntus, lossis lwm hnub kho yuav raug qhia.

Trivaris Description

Trivaris ™(triamcinolone acetonide injectable suspension) 80 mg/mL yog ib qho hluavtaws glucocorticoid corticosteroid nrog cov tshuaj tiv thaiv. Qhov no formulation yog haum rau intravitreal, intramuscular, thiab intra-articular siv. Cov formulation no tsis yog rau kev txhaj tshuaj intravenously. Txhua lub syringe ntawm sterile aqueous gel ncua kev kawm ntawv muaj 8 mg triamcinolone acetonide nyob rau hauv 0.1 mL (8% ncua kev kawm ntawv) nyob rau hauv ib lub tsheb HYLADUR ™ uas muaj w/w feem pua ​​ntawm 2.3% sodium hyaluronate; 0.63% sodium chloride; 0.3% sodium phosphate, dibasic; 0.04% sodium phosphate, monobasic; thiab dej rau txhaj tshuaj.Trivaris ™yog preservative-dawb nrog pH ntawm 7.0 txog 7.4. Lub npe tshuaj rau triamcinolone acetonide yog 9α-fluoro-11β,16α,17,21-tetrahydroxypregna-1,4-diene-3,20-dione cyclic 16,17-acetal nrog acetone.

Nws cov qauv qauv yog:

MW 434.50 nrog cov qauv molecular ntawm C24H31FO6. Triamcinolone acetonide tshwm sim raws li ib tug dawb mus rau cream-xim crystalline hmoov tsis muaj ntau tshaj ib tug me ntsis tsw, thiab yog xyaum insoluble nyob rau hauv dej thiab soluble heev nyob rau hauv cawv.

Trivaris - Clinical Pharmacology

Mechanism ntawm Action

Ib txwm tshwm sim glucocorticoids (hydrocortisone thiab cortisone), uas tseem muaj cov ntsev khaws cia, yog siv los hloov kho hauv cov xeev adrenocortical deficiency. Synthetic analogs xws li triamcinolone feem ntau yog siv rau lawv cov tshuaj tiv thaiv kab mob hauv cov kab mob ntawm ntau lub cev.

Corticosteroids inhibit qhov inflammatory teb rau ntau yam inciting agents thiab tej zaum yuav ncua los yog qeeb kho. Lawv inhibit qhov edema, fibrin deposition, capillary dilation, leukocyte migration, capillary proliferation, fibroblast proliferation, deposition ntawm collagen, thiab caws pliav tsim txuam nrog o. Tsis muaj kev lees paub feem ntau piav qhia txog cov txheej txheem ntawm kev ua ntawm ocular corticosteroids. Txawm li cas los xij, corticosteroids tau xav tias yuav ua los ntawm induction ntawm phospholipase A2 inhibitory proteins, sib sau ua ke hu ua lipocortins. Nws yog postulated tias cov proteins no tswj cov bio-synthesis ntawm lub zog nruab nrab ntawm kev mob xws li prostaglandins thiab leukotrienes los ntawm inhibiting kev tso tawm ntawm lawv cov precursor arachidonic acid. Arachidonic acid yog tso tawm los ntawm daim nyias nyias phospholipids los ntawm phospholipase A2. Corticosteroids muaj peev xwm ua kom muaj kev nce siab hauv lub cev.

Intravitreal corticosteroids tuaj yeem txo qis kev tsim cov tshuaj tiv thaiv kab mob, thiab tuaj yeem siv rau hauv cov kab mob ocular.

Pharmacokinetics

Aqueous humor pharmacokinetics ntawm triamcinolone acetonide tau soj ntsuam hauv 5 cov neeg mob tom qab kev tswj hwm ib leeg (4 mg) ntawm triamcinolone acetonide. Aqueous humor kuaj tau txais los ntawm 5 tus neeg mob (5 lub qhov muag) ntawm lub anterior chamber paracentesis rau Hnub 1, 3, 10, 17 thiab 31 tom qab txhaj tshuaj. Peak aqueous lom zem concentrations ntawm triamcinolone acetonide ranges ntawm 2,151 mus rau 7,202 ng / mL, lub neej ib nrab ntawm 76 mus rau 635 teev, thiab cheeb tsam nyob rau hauv lub concentration-lub sij hawm nkhaus (AUC0-t ib) ranges ntawm 231 mus rau 1,911 Μg∙h / mL. Qhov nruab nrab tshem tawm ib nrab-lub neej yog 18.7 ± 5.7 hnub hauv 4 lub qhov muag uas tsis muaj vitrectomized (4 tus neeg mob). Hauv ib tus neeg mob uas tau txais vitrectomy (1 lub qhov muag), kev tshem tawm ib nrab ntawm lub neej ntawm triamcinolone acetonide tau nrawm dua (3.2 hnub) txheeb ze rau cov neeg mob uas tsis tau txais vitrectomy.

Nonclinical Toxicology

Carcinogenesis, Mutagenesis, Impairment of Fertility

Tsis muaj kev tshawb fawb txaus tau ua nyob rau hauv cov tsiaj los txiav txim seb corticosteroids puas muaj peev xwm ua rau mob qog noj ntshav.

Triamcinolone acetonide tsis mutagenic los yog clastogenic nyob rau hauv Ames kab mob reversion test thiab chromosomal aberration assay nyob rau hauv Suav hamster zes qe menyuam (CHO) hlwb. Cov txiaj ntsig zoo tau raug sau tseg hauv kev sim hauv vivo micronucleus nrog triamcinolone acetonide hauv cov nas.

Cov tshuaj steroids tuaj yeem nce lossis txo qis zog thiab cov spermatozoa hauv qee cov neeg mob.

Yuav Ua Li Cas Muab / Cia thiab tuav

Trivaris ™(triamcinolone acetonide injectable suspension) 80 mg/mL yog muab rau hauv cov pob hlwv nrog 1 lub khob siv ib zaug uas muaj 8 mg hauv 0.1 mL raws li hauv qab no:

Syringe tsis muaj koob: NDC 0023-3457-01

Cia:Khaws cia hauv tub yees 36Cov-46CovF (2Cov-8CovC) mus txog rau thaum siv. Tsis txhob khov thiab tiv thaiv lub teeb.

Cov Ntaub Ntawv Qhia Txog Tus Neeg Mob

Cov neeg mob yuav tsum sab laj nrog lawv tus kws kho mob yog tias lawv tau kis tus kab mob tsis ntev los no lossis tsis tu ncua lossis yog lawv tau txais tshuaj tiv thaiv tsis ntev los no.

Muaj ntau cov tshuaj uas tuaj yeem cuam tshuam nrog corticosteroids xws li triamcinolone. Cov neeg mob yuav tsum ceeb toom rau lawv tus kws kho mob txog txhua yam tshuaj uas lawv noj, suav nrog cov tshuaj tom khw muag tshuaj thiab tshuaj noj (xws li phenytoin, diuretics, digitalis lossis digoxin, rifampin, amphotericin B, cyclosporine, insulin lossis tshuaj ntshav qab zib, ketoconazole, estrogens nrog rau cov tshuaj tiv thaiv kev yug menyuam thiab kev kho cov tshuaj hormones, cov ntshav thinners xws li warfarin, aspirin lossis lwm yam NSAIDs, barbiturates), cov khoom noj khoom haus, thiab tshuaj ntsuab. Yog tias cov neeg mob noj ib yam ntawm cov tshuaj no, lwm txoj kev kho mob, kev kho tshuaj, thiab / lossis kev kuaj tshwj xeeb yuav xav tau thaum kho.

Cov neeg mob yuav tsum tau qhia txog cov kev phiv tshwm sim uas tuaj yeem tshwm sim nrog kev siv corticosteroid kom suav nrog kev nce siab hauv cov hlab ntshav, cataracts, kua dej, hloov pauv hauv qabzib siab, nce ntshav siab, kev coj cwj pwm thiab lub siab xav, nce qab los noj mov thiab qhov hnyav nce.

Hauv cov hnub tom qab kev tswj hwm intravitrealTrivaris ™, cov neeg mob muaj kev pheej hmoo rau kev txhim kho endophthalmitis. Yog hais tias lub qhov muag liab, rhiab rau lub teeb, mob los yog tsim kev hloov hauv lub zeem muag, cov neeg mob yuav tsum nrhiav kev kho mob tam sim ntawd los ntawm tus kws kho mob ophthalmologist.

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®thiab ™ cov cim muaj los ntawm Allergan, Inc.

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