Kenalog
Isolating triamcinolone acetonide particles for intravitreal use with a porous membrane filter.

Nishimura A, Kobayashi A, Segawa Y, Sakurai M, Shirao E, Shirao Y, Sugiyama K.

Department of Ophthlamology, Kanazawa University Graduate School of Medical Science, Ishikawa Prefecture, Japan.

PURPOSE: To report a new, simple, rapid method to isolate triamcinolone acetonide particles and to remove additives from its commercially available suspension (Kenacort-A) for intravitreal use. METHODS: The contents of a Kenacort-A vial (40 mg triamcinolone acetonide suspended in 1.0 mL vehicle) were loaded into a syringe and passed through a porous membrane filter with 0.45-microm pores. The filter was then backflushed with distilled water to yield a vehicle-poor suspension of triamcinolone acetonide in the initial syringe. This filtration and backflush procedure was repeated four times, and each waste filtrate was subjected to high-performance liquid chromatography to identify benzyl alcohol, a preservative in the vehicle. Gel permeation chromatography was also used to determine the degree to which carboxymethylcellulose, one of the two suspending agents in the vehicle, permeated the membrane filter. Although 7.5 mg/mL high-viscosity carboxymethylcellulose hardly passed through the 0.45-microm pore filter, it passed through the 5.0-microm pore filter easily. Therefore, a 5.0-microm pore filter was used in this study. RESULTS: By using a 0.45-microm porous membrane filter, 99.7% of the benzyl alcohol can be eliminated. By using a 5.0-microm porous membrane filter, but not by using a 0.45-microm porous membrane filter, 88.1% of the high-viscosity carboxymethylcellulose can be eliminated. CONCLUSIONS: The filtration and backflush procedure using the 5.0-microm porous membrane filters is useful during vitrectomy to reduce the preparation time of triamcinolone acetonide suspension. Also, this method of reducing additives may be more helpful when using triamcinolone as a therapeutic agent for intravitreal depot use, because there is no washout effect when it is used in this manner.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14707826&dopt=Abstract triamcinolone Kenalog



Kenalog
Potentiation of triamcinolone-induced cleft palate in mice by maternal high dietary fat.

Zhou M, Walker BE.

Department of Anatomy, Michigan State University, East Lansing 48824-1316.

This study investigated whether the current range in dietary fat levels, which has arisen partly in response to some major health concerns, would affect frequency of congenital anomalies if continued into the period of early pregnancy. The effect of 5.6%, or 48% of calories from fat in the maternal diet, was tested on pregnant strain CD-1 mice injected with triamcinolone in doses of 0.01 mg, 0.02 mg, 0.04 mg, or 0.06 mg per day on days 11 through 14 of gestation. Frequency of cleft palate increased with increasing doses of triamcinolone, with clefts of the palate being rare at the two lower doses. No clefts appeared without triamcinolone on either diet. In combination with triamcinolone treatment, 226 fetuses exposed to a maternal low fat diet had normal palates and 86 had cleft palates. With exposure to high fat, 186 fetuses had normal palates and 101 had cleft palates, which was a significant increase in clefting (p < 0.05). Also, the latter group showed a greater degree of retardation in palate development (p < 0.05). Thus both a greater frequency and a more severe form of clefting support the conclusion that high dietary fat potentiated the cleft palate-producing effects of triamcinolone in mice.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8351648&dopt=Abstract triamcinolone Kenalog



Kenalog
Subcutaneous injection of triamcinolone acetonide in the treatment of chronic vulvar pruritus.

Kelly RA, Foster DC, Woodruff JD.

Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD.

OBJECTIVES: We studied the efficacy of subcutaneous corticosteroid injection as therapy for chronic vulvar pruritus. STUDY DESIGN: Adult women with symptoms of vulvar pruritus > 6 months were studied. After appropriate biopsies and cultures were performed, patients were included in the study group if they experienced limited relief with topical triamcinolone cream. Triamcinolone acetonide (15 to 20 mg) was injected subcutaneously and massaged into the affected vulvar tissue. RESULTS: Seventy-eight percent of patients (35/45) experienced relief of vulvar pruritus for > 1 month (mean duration 5.8 months). CONCLUSIONS: We found that subcutaneous injection triamcinolone acetonide provided relief of symptoms of chronic vulvar pruritus.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8372864&dopt=Abstract triamcinolone Kenalog



Kenalog
Triamcinolone and prednisolone affect contractile properties and histopathology of rat diaphragm differently.

Dekhuijzen PN, Gayan-Ramirez G, de Bock V, Dom R, Decramer M.

Respiratory Muscle Research Unit, University Hospital, Katholieke Universiteit Leuven, Belgium.

Diaphragm atrophy and weakness occur after administration of massive doses of corticosteroids for short periods. In the present study the effects of prolonged administration of moderate doses of fluorinated and nonfluorinated steroids were investigated on contractile properties and histopathology of rat diaphragm. 60 rats received saline, 1.0 mg/kg triamcinolone, or 1.25 or 5 mg/kg i.m. prednisolone daily for 4 wk. Respiratory and peripheral muscle mass increased similarly in control and both prednisolone groups, whereas triamcinolone caused severe muscle wasting. Maximal tetanic tension averaged 2.23 +/- 0.54 kg/cm2 (SD) in the control group. An increased number of diaphragmatic bundles in the 5-mg/kg prednisolone group generated maximal tetanic tensions < 2.0 kg/cm2 (P < 0.05). In addition, fatigability during the force-frequency protocol was most pronounced in this group (P < 0.05). In contrast, triamcinolone caused a prolonged half-relaxation time and a leftward shift of the force-frequency curve (P < 0.05). Histological examination of the diaphragm showed a normal pattern in the control and 1.25-mg/kg prednisolone group. Myogenic changes, however, were found in the 5-mg/kg prednisolone group and, more pronounced, in the triamcinolone group. Selective type IIb fiber atrophy was found in the latter group, but not in the prednisolone groups. In conclusion, triamcinolone induced type IIb fiber atrophy, resulting in reduced respiratory muscle strength and a leftward shift of the force-frequency curve. In contrast, 5 mg/kg prednisolone caused alterations in diaphragmatic contractile properties and histological changes without fiber atrophy.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8376603&dopt=Abstract triamcinolone Kenalog



Kenalog
Reconstruction after Mohs cancer excision.

Rudolph R, Miller SH.

Division of Plastic and Reconstructive Surgery, Scripps Clinic and Research Foundation, La Jolla, California.

At our institution, 363 skin defects following Mohs excision for carcinoma were repaired in a two-year period. The majority of the patients were women (62%). Most repairs were to the nose (42%), and almost all followed basal cell carcinoma excision (91% of tumor types). Flaps were preferable to skin grafts for facial repair, with forehead and nasolabial flaps particularly useful for the nose. Injection of Kenalog (triamcinolone acetonide, 5-20 mg/mL) speeds the maturation of scars and flaps.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8420704&dopt=Abstract triamcinolone Kenalog



Kenalog
The effects of intravitreal triamcinolone acetonide on experimental pre-retinal neovascularization.

Antoszyk AN, Gottlieb JL, Machemer R, Hatchell DL.

Department of Ophthalmology, Duke University, Durham, N.C.

Corticosteroids, alone or in combination with other drugs, have been shown to inhibit angiogenesis. The purpose of this study was to evaluate the efficacy of triamcinolone acetonide in a new model of preretinal neovascularization. Rabbit eyes were treated with intravitreal triamcinolone acetonide 24 h before partial liquefaction of the posterior vitreous with hyaluronidase and injection of 250,000 homologous tissue-cultured dermal fibroblasts. Triamcinolone acetonide effectively inhibited new vessel growth in treated eyes. Only 14% of the treated eyes developed new blood vessels compared to 100% of sham-injected control eyes (P < 0.001). These results suggest that intravitreal triamcinolone acetonide might be effective in inhibiting new vessel growth in patients with inflammatory retinal neovascularization, such as that associated with sarcoidosis or other uveitic syndromes.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8428678&dopt=Abstract triamcinolone Kenalog