| Feature | Description | |---------|-------------| | **Definition** | Synthetic derivatives of the naturally occurring male sex hormone testosterone. | | **Purpose** | Primarily used to increase muscle mass and strength; in medicine they treat hormonal deficiencies or diseases that reduce muscle mass (e.g., cachexia, AIDS‑related wasting). | | **Forms & Administration** | • Oral tablets/soft gels • Injectable esters (intramuscular) • Transdermal patches or gels |
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## 2️⃣ Who Uses Them?
| Population | Common Indications / Reasons | |------------|------------------------------| | **Athletes / Bodybuilders** | Performance enhancement, muscle hypertrophy. | | **Patients with Testosterone Deficiency** | Hypogonadism, delayed puberty, certain cancers (e.g., prostate). | | **Chronic Illness & Cachexia** | AIDS, COPD, cancer‑related wasting. | | **Elderly & Frail Individuals** | To mitigate sarcopenia and frailty. |
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## 3️⃣ How They’re Administered
| Method | Typical Dosage (varies by indication) | |--------|---------------------------------------| | **Oral Pills** | 100–500 mg/day for hormone replacement; lower doses for anti‑androgen therapy. | | **Transdermal Gels** | 25–75 mg per day, applied to clean skin. | | **Injectable Preparations** | Intramuscular or subcutaneous injections every 1–2 weeks (e.g., testosterone cypionate). |
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## 4️⃣ Benefits
- **Improved Muscle Mass & Strength:** ↑ protein synthesis and muscle fiber hypertrophy. - **Enhanced Fat‑Free Mass:** ↓ body fat percentage, better metabolic profile. - **Better Bone Density:** ↓ osteoporosis risk. - **Elevated Energy & Mood:** ↑ motivation, reduced fatigue. - **Cardiovascular Health:** Improved lipid profiles (↑ HDL, ↓ LDL).
**Mitigation:** - Use the lowest effective dose. - Prefer injectable (parenteral) forms to reduce hepatic burden. - Routine labs: CBC with reticulocyte count, LFTs, fasting lipids every 3–6 months.
| **Drug** | **Formulation & Route** | **Half‑Life (IV)** | **Clinical Use** | **Key Adverse Effects** | |----------|------------------------|--------------------|------------------|-------------------------| | **Epoetin alfa** | SC/IV | 8–12 h | Anemia of chronic kidney disease, chemotherapy | Hypertension, thromboembolism | | **Darbepoetin alfa** | IV | ~30 h (long‑acting) | Same indications; less frequent dosing | Similar to epoetin | | **Methoxy polyethylene glycol‑epoetin β** (Mircera) | SC | 15–21 d | CKD anemia, longer intervals | Hypertension, thrombosis | | **Asparaginase** | IV (in leukemia) | Variable | Inhibition of protein synthesis; leads to hypoalbuminemia | Hypoalbuminemia, pancreatitis |
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## 4. Suggested Follow‑Up
| Time Point | Action | |------------|--------| | Within 24 h | Reassess serum albumin, electrolytes (Na⁺, K⁺), BUN/Cr; evaluate hydration status. | | 48–72 h | Repeat albumin if >5 % drop or symptomatic hypoalbuminemia. | | Day 7 | Review clinical status and repeat albumin; assess for new symptoms. | | At discharge | Provide education on signs of fluid overload, nutrition, and medication adherence. |
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### Bottom Line
- A 5 % drop in serum albumin (from 3.9 g/dL to 3.7 g/dL) over one day is a **clinically significant** change that may reflect increased capillary leakage or fluid shifts. - Immediate assessment of the patient’s volume status, vital signs, and clinical symptoms is warranted; treat accordingly with diuretics, albumin infusion, or other supportive measures as indicated. - Monitor serum albumin serially to track trends and guide ongoing management.
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