Anabolic Steroids

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Chapter: Essential pharmacology : Androgens and Drugs for Erectile Dysfunction

These are synthetic androgens with supposedly higher anabolic and lower androgenic activity. Drugs are Nandrolone, Oxymetholone, Stanozolol and Methandienone.


ANABOLIC STEROIDS

 

These are synthetic androgens with supposedly higher anabolic and lower androgenic activity. Drugs are Nandrolone, Oxymetholone, Stanozolol and Methandienone.

 

The anabolic : androgenic activity ratio is determined by injecting the drug in castrated rats and measuring the increase in weight of levator ani muscles to that of ventral prostate. The anabolic : androgenic ratio of testosterone is considered as 1; The anabolic selectivity of these steroids is modest with ratios between 1 to 3 in the rat model, and probably still lower in man. The anabolic effects are similar to that of testosterone and are mediated through the same receptor as the androgenic effects; for all practical purposes, they are androgens.


Preparations And Dose

 

1. Methandienone: 2–5 mg OD–BD oral; children 0.04 mg/kg/day, 25 mg i.m. weekly; ANABOLEX 2, 5 mg tab, 2 mg/ml drops, 25 mg/ml inj.

 

2. Nandrolone phenyl propionate: 10–50 mg; children 10 mg; i.m. once or twice weekly; DURABOLIN 10, 25 mg/ ml inj.

 

3. Nandrolone decanoate: 25–100 mg i.m. every 3 weeks, DECADURABOLIN, 25, 100 mg/ml inj.

 

4. Oxymetholone: 5–10 mg, children 0.1 mg/kg, OD; ADROYD 5 mg tab.

 

5. Stanozolol: 2–6 mg/day, MENABOL, NEURABOL, TANZOL 2 mg tab.

 

Combination of anabolic steroids with any other drug is banned in India.

 

Side Effects

 

Anabolic steroids were developed with the idea of avoiding the virilizing side effects of androgens while retaining the anabolic effects. But the same side effect profile applies to these compounds.

 

The 17alkyl substituted compounds oxymetholone, stanozolol, can produce jaundice and worsen lipid profile.

 

Contraindications are same as for testosterone.

 

Uses

 

1. Catabolic States

Acute illness, severe trauma, major surgery, etc. are associated with negative N balance. Anabolic steroids can reduce N2 loss over short periods, but long term benefits are questionable. They may cause a transient response in the elderly, undernourished or debilitated individuals, but controlled studies have failed to demonstrate a difference in the total weight gained. However, short term use may be made during convalescence for the sense of wellbeing and improvement in appetite caused by such treatment.

 

2. Renal Insufficiency

Anabolic steroids reduce urea production—frequency of dialysis needed in renal failure can decrease. However, because this effect is short lasting, only transient improvement is seen in chronic renal failure.

 

3. Osteoporosis

In elderly males and that occurring due to prolonged immobilization may respond to anabolic steroids, but bisphosphonates are preferred now.

 

4. Suboptimal Growth In Boys

Use is controversial; somatropin is a better option. Brief spurts in linear growth can be induced by anabolic steroids, but this probably does not make a difference in the final stature, except in hypogonadism. Use for more than 6 months is not recommended—premature closure of epiphyses and shortening of ultimate stature may result.

 

5. Hypoplastic, Haemolytic And Malignancy Associated Anaemia

Majority of properly selected patients respond with an increase in RBC count and Hb%. However, erythropoietin therapy is more effective.

 

6. To Enhance Physical Ability In Athletes

When administered during the period of training, anabolic steroids can increase the strength of exercised muscles. However, effects are transient and contrary to popular belief, there is no scientific evidence that performance is enhanced except in women. This is considered an abuse and anabolic steroids are included in the list of ‘dope test’ performed on athletes before competitive games.

  

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