Intra articular steroid injection indications

IT SHOULD BE EMPHASIZED THAT DOSAGE REQUIREMENTS ARE VARIABLE AND MUST BE INDIVIDUALIZED ON THE BASIS OF THE DISEASE UNDER TREATMENT AND THE RESPONSE OF THE PATIENT. After a favorable response is noted, the proper maintenance dosage should be determined by decreasing the initial drug dosage in small decrements at appropriate time intervals until the lowest dosage which will maintain an adequate clinical response is reached. Situations which may make dosage adjustments necessary are changes in clinical status secondary to remissions or exacerbations in the disease process, the patient’s individual drug responsiveness, and the effect of patient exposure to stressful situations not directly related to the disease entity under treatment. In this latter situation it may be necessary to increase the dosage of the corticosteroid for a period of time consistent with the patient’s condition. If after long-term therapy the drug is to be stopped, it is recommended that it be withdrawn gradually rather than abruptly.

This product contains benzyl alcohol as a preservative. Benzyl alcohol, a component of this product, has been associated with serious adverse events and death, particularly in pediatric patients. The “gasping syndrome” (characterized by central nervous system depression, metabolic acidosis, gasping respirations, and high levels of benzyl alcohol and its metabolites found in the blood and urine) has been associated with benzyl alcohol dosages > 99 mg/kg/day in neonates and low-birth-weight neonates. Additional symptoms may include gradual neurological deterioration, seizures, intracranial hemorrhage, hematologic abnormalities, skin breakdown, hepatic and renal failure, hypotension, bradycardia , and cardiovascular collapse. Although normal therapeutic doses of this product deliver amounts of benzyl alcohol that are substantially lower than those reported in association with the “gasping syndrome,” the minimum amount of benzyl alcohol at which toxicity may occur is not known. Premature and low-birth-weight infants, as well as patients receiving high dosages, may be more likely to develop toxicity. Practitioners administering this and other medications containing benzyl alcohol should consider the combined daily metabolic load of benzyl alcohol from all sources.

Williams JS Jr, Abate JA, Fadale PD, Tung GA: Meniscal and nonosseous ACL injuries in children and adolescents. Am J Knee Surg 9:22-6,1996.
Wright TW, Cooney WP, Ilstrup DM: Anterior wrist ganglion. J Hand Surg 19:954-8,1994.
Yasuda K, Majima T: Intra-articular ganglion blocking extension of the knee: brief report. J Bone Joint Surg 70B:837,1988.
Young SC, Freiberg A: A case of intratendinous ganglion. J Hand Surg 10:723-4,1985.
Zubowicz VN, Ishii CH: Management of ganglion cysts of the hand by simple aspiration. J Hand Surg 12A:618-20,1987.

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Intra articular steroid injection indications

intra articular steroid injection indications

Home  |  About Us  |  Our Providers  |  Careers  |  Services  |  Conditions & Treatments  |  Patient Information  |  Referring Offices  |  Locations  |  Offices
Schedule An Appointment  |  New Patient Packet  |  Refer A Patient  |  New Patient Referral Form  |  Procedure Specific Referral Form
Notice of Privacy Practices  |  Website Privacy Policy  |  Legal Notice/Disclaimer

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