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Anticoagulants: Patients on anticoagulants such as warfarin should be carefully monitored during anabolic steroid therapy as anabolic steroids may increase sensitivity to oral anticoagulants which may require a concomitant reduction in anticoagulant dosage to achieve a desirable prothrombin time (PT). Anticoagulant patients should be monitored regularly during anabolic steroid therapy, particularly during initiation and termination of therapy. Warfarin patients should have INR and PT monitored throughout androgen therapy and warfarin dosages titrated to achieve the desired INR and PT. Such patients should be monitored for occult bleeding.

Oxandrolone is a mild, low androgen 17-alpha alkylated anabolic steroid with very low toxicity. It promotes protein anabolism and has a low incidence of adverse reactions. Oxandrolone is primarily used to promote strength, muscle hardness and quality physique improvement. In the International Journal of Obesity, (1995; 19: 614-624), it was shown that Oxandralone enhanced body fat reduction significantly in both the abdominal and visceral stores. Oxandrolone will not aromatize, and therefore the anabolic effect of this compound can actually promote linear growth.

Winstrol® is a popular brand name for the anabolic steroid stanozolol. This compound is a derivative of dihydrotestosterone, although its activity is much milder than this androgen in nature. It is technically classified as an anabolic steroid, shown to exhibit a slightly greater tendency for muscle growth than androgenic activity in early studies. While dihydrotestosterone really only provides androgenic side effects when administered, stanozolol instead provides quality muscle growth. Admittedly the anabolic properties of this substance are still mild in comparison to many stronger compounds, but it is still a reliable builder. Its efficacy as an anabolic could even be comparable to Dianabol, however Winstrol® does not carry with it the same tendency for water retention. Stanozolol also contains the same c17 methylation we see with Dianabol, an alteration used so that oral administration is possible. To spite this design however, there are many injectable versions of this steroid produced. Structurally stanozolol is not capable of converting into estrogen. Likewise an antiestrogen is not necessary when using this steroid, gynecomastia not being a concern even among sensitive individuals. Since estrogen is also the culprit with water retention, instead of bulk Winstrol® produces a lean, quality look to the physique with no fear of excess subcutaneous fluid retention. This makes it a favorable steroid to use during cutting cycles, when water and fat retention are a major concern. It is also very popular among athletes in combination strength/speed sports such as Track and Field. In such disciplines one usually does not want to carry around excess water weight, and may therefore find the raw muscle-growth brought about by Winstrol® quite favorable over the lower quality mass gains of more estrogenic agents. Have been noticed when trying to administer these products, even when using a large 22-gauge needle. But there are both advantages and disadvantages to each type of product. On the one hand the large particle size would form a longer acting deposit (depot) while the steroid dissolves, giving us the option of fewer injections. A larger shot every three to four days would likely be sufficient to keep blood levels within limits, which is a favorable schedule for a water-based product. On the other hand we are forced to use a standard size oil

Anabolic steroids are synthetic derivatives of testosterone . Certain clinical effects and adverse reactions demonstrate the androgenic properties of this class of drugs. Complete dissociation of anabolic and androgenic effects has not been achieved. The actions of anabolic steroids are therefore similar to those of male sex hormones with the possibility of causing serious disturbances of growth and sexual development if given to young children. Anabolic steroids suppress the gonadotropic functions of the pituitary and may exert a direct effect upon the testes .

LABORATORY CONTROL: The PT reflects the depression of vitamin K dependent Factors VII, X and II. A system of standardizing the PT in oral anticoagulant control was introduced by the World Health Organization in 1983. It is based upon the determination of an International Normalized Ratio (INR) which provides a common basis for communication of PT results and interpretations of therapeutic ranges. 17 The PT should be determined daily after the administration of the initial dose until PT/INR results stabilize in the therapeutic range. Intervals between subsequent PT/INR determinations should be based upon the physician's judgment of the patient's reliability and response to Jantoven (warfarin sodium tablets) ® Tablets in order to maintain the individual within the therapeutic range. Acceptable intervals for PT/INR determinations are normally within the range of one to four weeks after a stable dosage has been determined. To ensure adequate control, it is recommended that additional PT tests be done when other warfarin products are interchanged with warfarin sodium tablets, USP, as well as whenever other medications are initiated, discontinued, or taken irregularly (see PRECAUTIONS ). Safety and efficacy of warfarin therapy can be improved by increasing the quality of laboratory control. Reports suggest that in usual care monitoring, patients are in therapeutic range only 33%-64% of the time. Time in therapeutic range is significantly greater (56%-93%) in patients managed by anticoagulation clinics, among self-testing and self-monitoring patients, and in patients managed with the help of computer Self-testing patients had fewer bleeding events than patients in usual care. 18

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Anabolic steroids are synthetic derivatives of testosterone . Certain clinical effects and adverse reactions demonstrate the androgenic properties of this class of drugs. Complete dissociation of anabolic and androgenic effects has not been achieved. The actions of anabolic steroids are therefore similar to those of male sex hormones with the possibility of causing serious disturbances of growth and sexual development if given to young children. Anabolic steroids suppress the gonadotropic functions of the pituitary and may exert a direct effect upon the testes .

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