Kenalog ampoules 40mg/1ml №5

GCS, inhibits the release of interleukin - 1, 2, gamma Interferon from lymphocytes and macrophages. Induces the formation of lipocortins, inhibits the release of inflammatory mediators by eosinophils, reduces the number and stabilizes the membranes of mast cells. It has anti-inflammatory, anti-allergic, anti-edema, anti-proliferative and immunosuppressive effects. Reduces bronchial hyperreactivity, restores the sensitivity of receptors to beta-adrenostimulyatorov. Stabilizes the membranes of mast cells, inhibits the activity of phospholipase A2, reduces the release of arachidonic acid from the phospholipids of cell membranes and the formation of its metabolic products (Pg, Tx, leukotrienes). Antiallergic effect develops as a result of suppression of the synthesis and secretion of allergy mediators, inhibition of release from sensitized mast cells and histamine basophils and other biologically active substances, reduction in the number of circulating basophils, suppression of the development of lymphoid and connective tissue, reduction in the number of T and B lymphocytes, fat cells, reducing the sensitivity of effector cells to mediators of allergy, inhibition of antibody production, changes in the immune response of the body. Anti-shock and anti-toxic effects are associated with an increase in blood pressure (by increasing the concentration of circulating catecholamines and restoring sensitivity of adrenoreceptors to them, as well as vasoconstriction), reducing vascular permeability, membrane-protective properties, activation of liver enzymes involved in endo-and xenobiotic metabolism. Suppresses the release of pituitary ACTH and beta-lipotropin, but does not reduce the level of circulating beta-endorphin. It inhibits the secretion of TSH and FSH. Increases the excitability of the central nervous system, reduces the number of lymphocytes and eosinophils, increases - red blood cells (stimulates the production of erythropoietin). It has a pronounced dose-dependent effect on the metabolism of carbohydrates, proteins and fats. Increases glycogenesis, enhances the breakdown of fat, retains Na + and water, promotes the excretion of K +, reduces the absorption of Ca2 +, induces the secretion of parathyroid hormone that mobilizes Ca2 + from bone tissue. Activates catabolic processes.Triamcinolone is close to Hydrocortisone in anti-inflammatory activity, triamcinolone acetonide is 6 times more active. Mineralocorticoid activity is practically absent. After i / m administration, the maximum effect is observed after 24-48 hours, the duration of action with i / m administration is 1-6 weeks, into the joint cavity - several weeks.

Indications and usage

V / m: adrenal insufficiency, autoimmune thyroiditis, hypercalcemia in patients with malignant tumors, persistent non-infectious dermatosis, rheumatoid arthritis, generalized progressive polyarthritis, connective tissue diseases, SLE, pulmonary emphysema and pulmonary fibrosis, lymphosarcoma, lymphoma, lymphoma, lymphosarcoma, lymphatic lymphoma, lymphocytic syndrome allergic diseases. Intra-articular, inside the articular bags, in the tendon sheaths: bursitis, traumatic arthritis, synovitis, tendonitis. In / to: localized hypertrophic, infiltrative or inflammatory lesions: chronic psoriasis (limited neurodermatitis), psoriasis, annular granuloma, lichen planus, keloid scars, alopecia areata, total alopecia.

Contraindications

Hypersensitivity, mycoses (especially systemic), glaucoma, history of acute psychosis, tuberculosis (active form), herpes age, myasthenia, metastasis neoplasms, diverticulitis, gastric ulcer and duodenal ulcer, arterial hypertension, itchromic syndrome, syndrome, and developing syndrome, and developing syndrome, and ulcer disease, gastric and duodenal ulcer, arterial hypertension, Iceros syndrome, and developing syndrome, and developing syndrome, and gastrointestinal ulcer, duodenal ulcer to thrombosis, osteoporosis, diabetes mellitus, hidden foci of infection, amyloidosis, syphilis, viral and bacterial infections, polio (with the exception of the bulbar-encephalitic form), gonococcal or tuberculous arthritis, d vaccination, lymphadenitis after BCG vaccination, pregnancy (especially I trimester), lactation period, child age (up to 6 years). With caution - obesity, edematous syndrome, mental illness, gastrointestinal diseases, children (6-12 years old)

V / m, deep into the muscle. Adults and children over 12 years old - 40-80 mg, if necessary, again after 4 weeks, may increase the dose to 100 mg.For children 6–12 years old, the initial dose is 40 mg, with a repeated injection after 4 weeks as needed, or 0.03–0.2 mg / kg (again after 1–7 days). After a single intramuscular injection in a dose of 60-100 mg, suppression of the function of the adrenal cortex develops within 24-48 hours; return to normal usually occurs in 30-40 days. Intra-articular administration - 10 mg for a small area and 40 mg - for a large area; it is possible to increase the dose to 80 mg, for small joints - 2.5-5 mg, for large ones - 5-15 mg, maybe 20 mg. In / to (n / a injection) - the volume of a substance injected into one place should not exceed 0.1 ml in order to avoid atrophy. Injections can be repeated at weekly and longer intervals; use syringes for the introduction of tuberculin and thin needles with a diameter of 0.61-0.51 mm.

Adverse reactions

On the part of the digestive system: nausea, vomiting, bulimia, steroid ulcers in the digestive tract, bleeding from ulcers, perforation of the intestinal wall, intestinal atony, pancreatitis, hepatomegaly. On the part of the cardiovascular system: bradycardia, increased blood pressure, arrhythmias, exacerbation of the phenomena of heart failure, myocardial dystrophy, steroid vasculitis. Nervous system disorders: epilepsy, convulsions, cranial hypertension, fatigue, sleep disorders, mood disorders, psychosis, dizziness, headache. On the part of the endocrine system: dysmenorrhea, Itsenko-Cushing syndrome, atrophy of the adrenal cortex, hyperglycemia, steroid diabetes, adrenal insufficiency (especially during stress - with trauma, surgery, concomitant diseases), "moon form", hirsutism, stria, acne. On the part of the senses: visual impairment, posterior subcapsular cataract, steroid exophthalmos or increased intraocular pressure. On the part of metabolism: fluid retention, sodium, hypokalemia, hyperlipoproteinemia, impaired nitrogen metabolism (negative nitrogen balance), weight gain, catabolic effect, slower growth of children. On the part of the musculoskeletal system: muscle weakness, loss of muscle mass, myopathy, osteoporosis, aseptic necrosis of the femoral head, compression fractures of the vertebrae, pathological fractures of the tubular bones. On the part of the hemostasis system: hypercoagulation, thromboembolism.Effect on the fetus: with prolonged use during pregnancy - a violation of fetal growth, in the third trimester - atrophy of the adrenal cortex in the fetus. On the part of the skin: slow wound healing, thinning of the skin, sweating, flushing of the skin of the face, petechiae, ecchymosis, allergic dermatitis. Other: immunosuppression (exacerbation of infectious diseases), "cancellation" syndrome (not caused by hypocorticism): anorexia, nausea, lethargy, myalgia, ossalgia, general weakness, allergic reactions. Local reactions: with intraarticular administration - arthralgia, irritation at the injection site, depigmentation, sterile abscess, skin atrophy, resorptive side effects (at a dose of more than 40 mg). Overdose. Symptoms: Itsenko-Cushing syndrome, hyperglycemia, glycosuria. Treatment: symptomatic therapy on the background of gradual cancellation.

Special notes

Not intended for on / in the introduction. In children 6-12 years old, parenterally used for health reasons, at the age of 6-12 years - for strict indications. Children taking the drug are more susceptible to airborne infections than their healthy peers. With the introduction of the joint should avoid excessive stretching of the articular bag and follow.

Reduces the effectiveness of insulin, oral hypoglycemic drugs, antihypertensive drugs, anticoagulants; reduces the content of salicylates in the blood; reduces the concentration of praziquantel in the serum. Rifampicin, phenytoin, barbiturates - weaken the effect, hormonal contraceptives - increase efficiency. Increase the risk of side effects: NSAIDs (erosive and ulcerative lesions and bleeding from the gastrointestinal tract); androgens, estrogens, oral contraceptives, steroid anabolics (hirsutism, acne); antipsychotics, bucarban, azathioprine (cataract); holinoblokatory, antihistamines, tricyclic antidepressants, nitrates (glaucoma); saluretics (hypokalemia); cardiac glycosides (digitalis intoxication).