Intrapericardial triamcinolone for acute pericarditis after electrophysiologic procedures

American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
Carleton B Maxwell, Michael A Crouch

Abstract

The use of intrapericardial triamcinolone for acute pericarditis after electrophysiologic procedures in three patients is described. Treatment for idiopathic pericarditis and viral pericarditis, which account for about 85% of cases, focuses on pain management and decreasing pericardial inflammation. This is oftentimes achieved with nonsteroidal antiinflammatory drugs (NSAIDs). Colchicine may be used in combination with NSAIDs, specifically in postmyocardial infarction pericarditis and recurrent pericarditis. Because oral corticosteroid use has been shown to be an independent risk factor in pericarditis recurrence, their use in patients with refractory pericarditis is reserved as a last-resort option. Intrapericardial triamcinolone is an uncommon treatment approach, although it is recommended in select situations of pericarditis according to guidelines developed by the European Society of Cardiology. In this retrospective case series, three patients with pericarditis, tamponade, or both as a complication of radiofrequency ablation or implantable cardioverter defibrillator implantation received triamcinolone. The drug was instilled intrapericardially, with doses ranging from 50 to 200 mg. In two patients, the need for pain medica...Continue Reading

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Citations

Oct 13, 2011·Current Treatment Options in Cardiovascular Medicine·Dina M Sparano, R Parker Ward
Feb 26, 2016·Current Cardiology Reports·Mandeep BhargavaWalid I Saliba
Aug 26, 2010·The Annals of Pharmacotherapy·Jorie A Glick Frasiolas, William D Cahoon
Oct 27, 2012·Expert Review of Cardiovascular Therapy·W Douglas BoydJames L Cox

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