Effect of Long-Acting Parenteral Corticosteroids on Adrenal Function

Mikhail, George R.

doi:10.1001/archderm.1969.01610270005001

Cited by 26 publications

(18 citation statements)

References 17 publications

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“…As shown in the present case, intramuscular triameinolone acetonide could offer a significant advantage over orally administered steroids. We do not have a plausible explanation for this therapeutic effeet, but since an injection of 40 tng of triameinolone acetonide produces a suppressive effect on the adrenal gland for 4 weeks, we think that the effect on the skin lesions resulted from the long-acting, high levels of eireulating corticosteroid (13). It has been shown that intramuscular triameinolone is beneficial in the management of a variety of inflammatory dermatoses (14).…”

Section: Discussionmentioning

confidence: 99%

Intramuscular Triamcinolone Acetonide for Lupus Miliaris Disseminatus Faciei

Tokunaga¹,

Okuyama²,

Tagami³

et al. 2007

Acta Derm Venereol

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Section: Discussionmentioning

confidence: 99%

Intramuscular Triamcinolone Acetonide for Lupus Miliaris Disseminatus Faciei

Tokunaga¹,

Okuyama²,

Tagami³

et al. 2007

Acta Derm Venereol

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“…In patients, long-term i.m. administration of TAA (for 1-5 years at 3-6-week interval) caused a complete suppression of the HPA axis and adrenal function (Mikhail et al 1969, 1973, Carson et al 1975, Morimoto et al 1980. However, these data can only be partly compared, because TAA treatment has been carried out repeatedly at a certain time interval over a year, where the cumulative systemic effect increased upon multiple dosing for markers of pharmacodynamic activity, e.g.…”

Section: Resultsmentioning

confidence: 99%

Comparison of the hypothalamic–pituitary–adrenal axis susceptibility upon single-dose i.m. depot versus long-acting i.v. triamcinolone acetonide therapy: a direct pharmacokinetic correlation

Abraham

Demiraj

Ungemach

2006

Journal of Endocrinology

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The effects of single injections of glucocorticoid (GC) depot suspension and of long-acting GC were studied in conscious dogs. Both the depot suspension GC triamcinolone-16,17-aacetonide (TAA) and the long-acting triamcinolone acetonide-21-dihydrogen phosphate (TAA-DHP) decreased basal and ACTH-stimulated cortisol levels and in a specific timedependent way. Before treatment, all dogs had normal basal and peak cortisol responses to ACTH challenge (13-15 and O120 nmol/l at 1 h respectively). Intravenous TAA-DHP reduced cortisol levels for 12 h, i.m. TAA reduced cortisol levels as of 1 . 5 h and the effect lasted for at least 4 weeks. Both treatments blunted the peak response to ACTH. ACTH elevated cortisol levels to or above baseline values within 10 days following TAA-DHP treatment, but the TAA treatment suppressed an ACTH response for at least 4 weeks. Kinetic analysis of both the preparations demonstrated rapid absorption (t max , 0 . 6-1 . 5 h) and low maximum plasma concentrations (peak C max , 2 . . 51 nmol/l) of the steroids; indeed, the terminal half-life of TAA-DHP (13 . 9G1 . 3 h) was very much shorter than that of TAA (125 . 9G15 . 8 h). In addition, the mean residence time differed very much (11 vs 160 h for TAA-DHP and TAA respectively), in line with a delayed elimination of the depot compared with the long-acting formulation. Application of these TAA formulations needs careful evaluation for their surprisingly different effects on endocrine stress axis activity.

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“…Depot corticosteroids can cause the usual corticosteroid side effects including adrenal suppression which may last longer than the hay fever season, especially if more than one injection is given (McMillin, 1971;Mikhail et al, 1969;Ganderton & James, 1970). This suppression may encourage the development of asthma (Ganderton & James, 1970) and has caused reservations to be expressed regarding the use of steroids (Ganderton et ai, 1969;McAllen, 1972;Demos & Maurer, 1968); although several authors do not consider this to be a problem.…”

Section: Discussionmentioning

confidence: 99%

Hay fever treated with ACTH gel

Parr

1976

Clin Experimental Allergy

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Summary ACTH gel was used as a treatment for hay fever during the 1972–1974 hay fever seasons. Patients suffering from hay fever were given ACTH in different dose schedules and other hay fever patients were used as controls. Subjectively, those treated with ACTH gel were pleased with the results and reported more favourably on the injections than those receiving placebo. Objectively, using presence of any symptoms as the index of measurement, those treated with ACTH gel (80 units once weekly or 80 units twice weekly) had a significantly lower incidence of hay fever. Side effects were few.

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Effect of Long-Acting Parenteral Corticosteroids on Adrenal Function

Cited by 26 publications

References 17 publications

Intramuscular Triamcinolone Acetonide for Lupus Miliaris Disseminatus Faciei

Intramuscular Triamcinolone Acetonide for Lupus Miliaris Disseminatus Faciei

Comparison of the hypothalamic–pituitary–adrenal axis susceptibility upon single-dose i.m. depot versus long-acting i.v. triamcinolone acetonide therapy: a direct pharmacokinetic correlation

Hay fever treated with ACTH gel

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