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Anabolic Steroids: Classification, Mechanism of Action, Therapeutic Uses, Adverse Effects, and Contraindications
Classification of Anabolic Steroids
- Testosterone and its esters: Testosterone, testosterone enanthate, testosterone cypionate.
- Synthetic anabolic steroids: Nandrolone, stanozolol, oxandrolone.
Mechanism of Action
- Anabolic steroids bind to androgen receptors in tissues, resulting in increased protein synthesis and muscle growth.
- They promote a positive nitrogen balance, aiding in muscle repair and growth.
- Enhance red blood cell production through erythropoiesis.
- Excess androgenic effects may lead to viralization (development of male characteristics).
Therapeutic Uses
- Muscle-wasting conditions: Used in diseases such as cancer, AIDS, and chronic infections.
- Anemia: Stimulates red blood cell production, especially in chronic anemia.
- Hormonal replacement: Used in testosterone deficiency (hypogonadism).
- Osteoporosis: Helps increase bone density in men with low testosterone.
Adverse Effects
Cardiovascular Effects
- Increased risk of myocardial infarction and stroke.
- Hypertension.
Endocrine Effects
- Testicular atrophy, gynecomastia.
Psychiatric Effects
- Mood swings, aggression, depression, anxiety.
Liver Damage
- Hepatic dysfunction, hepatotoxicity, especially with oral steroids.
Others
- Acne, hair loss, masculinization in women.
Contraindications
- Prostate cancer: Testosterone may exacerbate growth of prostate cancer.
- Pregnancy and breastfeeding: Anabolic steroids are teratogenic and should not be used.
- Liver disease: Contraindicated in patients with liver cirrhosis or active liver disease due to hepatotoxicity risk.
