曲安奈德 (去炎松)

用途

• Glucocorticoid effects
• Pododermatitis, feline plasmacytic pharyngitis
• Pemphigus complex
• General therapy (Tablets)
• Inflammatory, allergic, or dermatological disorders (Injectable)
• Intralesional injection
• To prevent re-stricture after esophageal dilation
• Adjunctive treatment of miliary dermatitis
• Glucocorticoid effects
• Glucocorticoid effects
• Intra-articular injection
• Glucocorticoid effects
• Antiinflammatory effects
• General therapy (Tablets)
• Inflammatory, allergic, or dermatological disorders (Injectable)
• Intralesional injection
• To prevent re-stricture after esophageal dilation

給藥方式

可能的副作用

• Polyuria (PU)
• Polydipsia (PD)
• Polyphagia (PP)
• Weight gain
• Panting (dogs)
• Dull, dry haircoat
• Vomiting and diarrhea
• Elevated liver enzymes (e.g., ALP)
• Pancreatitis
• Gastrointestinal ulceration
• Lipidemias
• Insulin resistance / Activation of diabetes mellitus
• Muscle wasting
• Behavioral changes (depression, lethargy, viciousness)
• Iatrogenic hyperadrenocorticism (Cushing's syndrome) with chronic use
• Laminitis (horses)

注意事項與禁忌

• Systemic fungal infections
• Viral infections
• Active tuberculosis
• Peptic ulcers
• Corneal ulcers
• Acute psychoses
• Cushingoid syndrome
• Idiopathic thrombocytopenia (IM administration)
• Hypersensitivity to the drug
• > **Tapering Required:** Animals receiving systemic glucocorticoids (other than short 'burst' therapy) must be tapered off slowly to allow endogenous ACTH and adrenal function to recover. * **Stress Dosing:** If a patient undergoes a stressor (surgery, trauma, illness) during tapering, additional glucocorticoids should be administered. * **Pregnancy Warning:** Corticosteroid therapy may induce parturition in large animal species during the latter stages of pregnancy. Teratogenic effects are possible with excessive doses early in pregnancy (FDA Category C). * **Growth Retardation:** Can retard growth when administered to young, growing animals. * **Disease Exacerbation:** Use with extreme caution in patients with diabetes mellitus, osteoporosis, predisposition to thrombophlebitis, hypertension, congestive heart failure (CHF), and renal insufficiency.

藥物相互作用

• Amphotericin B: May cause hypokalemia when administered concomitantly
• Opiate Analgesics / Local Anesthetics (Epidural): Combination in epidurals has caused serious CNS injuries and death; restrict volume to very small intrathecal test doses
• Anticholinesterase Agents (e.g., pyridostigmine): May lead to profound muscle weakness in myasthenia gravis patients; discontinue 24h prior if possible
• Aspirin: Glucocorticoids may reduce salicylate blood levels
• Barbiturates: May increase the metabolism of glucocorticoids and decrease blood levels
• Cyclophosphamide: Glucocorticoids may inhibit hepatic metabolism of cyclophosphamide; dosage adjustments may be required
• Cyclosporine: May mutually inhibit hepatic metabolism, increasing blood levels of both drugs
• Potassium-depleting Diuretics (e.g., spironolactone): May cause hypokalemia
• Erythromycin, Clarithromycin: May increase triamcinolone levels
• Estrogens: May potentiate the effects of triamcinolone
• Insulin: Insulin requirements may increase due to glucocorticoid-induced insulin resistance
• Isoniazid: Triamcinolone may decrease isoniazid levels
• Ketoconazole and Azole Antifungals: May decrease metabolism of glucocorticoids; ketoconazole may induce adrenal insufficiency upon steroid withdrawal
• Mitotane: Higher than usual doses of steroids may be necessary to treat mitotane-induced adrenal insufficiency
• NSAIDs: Increased risk of gastrointestinal ulceration
• Phenobarbital: May increase the metabolism of glucocorticoids and decrease triamcinolone blood levels
• Rifampin: May increase the metabolism of glucocorticoids and decrease triamcinolone blood levels
• Vaccines: May augment viral replication of live vaccines; diminished immune response to killed vaccines/toxoids
• Warfarin: May affect INR; requires monitoring

常見問題