Triamcinolon

Triamcinolone, often encountered as triamcinolone acetonide in many preparations, is a synthetic corticosteroid with potent anti-inflammatory and immunosuppressive properties. It is used to treat a range of inflammatory and allergic disorders and is available in multiple forms, including topical creams and ointments, intra-articular and intralesional injections, intranasal sprays, inhaled formulations, and dental pastes.

Mechanism: Triamcinolone acts as an agonist at glucocorticoid receptors, altering gene transcription to reduce the production of inflammatory mediators, suppress leukocyte migration, and lessen edema and pruritus. These actions underlie its broad anti-inflammatory and immunosuppressive effects.

Common uses: In dermatology, it is employed for eczema, dermatitis, psoriasis, and other inflammatory skin conditions, as well as for mucosal or oral lesions in certain settings. Intranasal forms treat allergic rhinitis, while intra-articular or soft tissue injections address arthritis and tendinopathies. Intralesional injections are used for keloids and hypertrophic scars. Dental pastes containing triamcinolone acetonide have been used for mucosal inflammation and ulcers. Historical inhaled preparations have been used for asthma, though modern practice often relies on other inhaled corticosteroids.

Safety and side effects: Systemic adverse effects may occur with long-term use, including suppression of the hypothalamic-pituitary-adrenal axis, osteoporosis, growth suppression in children, hyperglycemia, and cataracts. Local topical therapy can cause skin thinning or atrophy; intranasal use may cause nasal irritation or epistaxis; inhaled forms can lead to oral thrush; injections may cause pain or infection at the site. Use in pregnancy or lactation requires careful risk-benefit assessment, and dosing should be the lowest effective amount for the shortest duration.

Brand names include Kenalog (injectable), Nasacort (intranasal), and various topical preparations.