triamcinolone inhaled (Discontinued)

Brand and Other Names:Azmacort
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

inhaler

  • 55mcg/inh
  • 100mcg/inh
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Asthma

Discontinued in the United States in 2010

Inhaler: 2 puffs (150 mcg) TID/QID; no more than 16 puffs/day

Discontinue if inadequate relief after 3 weeks

Dosage Forms & Strengths

inhaler

  • 55mcg/inh
  • 100mcg/inh
more...

Asthma

6-12 years old: 1-2 puffs (75-150 mcg) TID/QID

No more than 12 puffs/day

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Adverse Effects

>10%

Pharyngitis (25%)

Headache (21%)

1-10%

Flu syndrome (5%)

Sinusitis (4%)

Back pain (2%)

Frequency Not Defined

Bronchospasm

Cough

Dry throat/mouth

Oral candidiasis (rare)

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Warnings

Contraindications

Acute bronchospasm

Hypersensitivity

(Nasal Spray): nasal injury/surgery (until healed)

Caution

TB, other serious infections, Glaucoma, incr IOP, cataracts, immunocompromised pts

Must be used regularly: NOT PRN

Chickenpox & measles: serious or fatal course in susceptible individuals

  • Unvaccinated or immunologically unexposed children or adults should avoid exposure

Transferring pts from systemic corticosteroids; withdrawal of systemic corticosteroids may cause adrenal insufficiency, taper off gradually

Risk of infections of nose & pharynx, including Candida albicans

Excessive use may suppress HPA function

During periods of stress or severe status asthmaticus, may require supplementary systemic corticosteroids immediately

  • Carry warning card to that effect

Metered-dose inhalers that contain chlorofluorocarbons (CFCs) are currently being phased out in the United States; alternate inhalers without CFCs are available

Inhaler: contents under pressure

Nasal spray: prime initially with 5 sprays

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Pregnancy & Lactation

Pregnancy Category: C

Lactation: not known if excreted in breast milk

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

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Pharmacology

Half-Life: 88 min

Onset: 1-2 wk

Protein Bound: 68%

Vd: 99.5 L

Metabolites: 6 beta-hydroxytriamcinolone acetonide, 21-carboxytriamcinolone acetonide and 21-carboxy-6 beta-hydroxytriamcinolone acetonide

Clearance: 45.2 L/hr

Excretion: feces & urine

Mechanism of Action

Glucocorticoid: anti-inflammatory, precise mechanism unknown

Effective local steroid activity with minimal systemic effects

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Images

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