Clinical Pharmacology for Allied Health: Nandrolone Essay

This essay provides a comprehensive overview of the pharmacological management of Nandrolone, an anabolic steroid, for allied health professionals. It begins by introducing Nandrolone, its uses, and its classification as a 19-nortestosterone derivative. The essay explores Nandrolone's mechanism of action, highlighting its role in managing conditions like anaemia and osteoporosis in menopausal women. It also discusses the drug's effects on bone density, muscle mass, and its potential misuse in sports, along with associated side effects and contraindications. Furthermore, the essay emphasizes the importance of understanding drug interactions, ethical considerations, and the role of interprofessional communication among healthcare professionals in ensuring effective and safe pharmacological management. The essay concludes by summarizing key points, including the need for health professionals to stay informed about Nandrolone's clinical applications and potential adverse effects, and the importance of implementing standardized procedures for optimal patient outcomes. The essay also highlights the contraindications for Nandrolone, including pregnancy, breastfeeding, and certain medical conditions.

Running head: PHARMACOLOGICAL MANAGEMENT OF NANDROLONE
PHARMACOLOGICAL MANAGEMENT OF NANDROLONE
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1PHARMACOLOGICAL MANAGEMENT OF NANDROLONE
Nandrolone is an anabolic steroid, which aids in tissue building process in the body. It
is commonly used to manage anaemia in menopausal women. Nandrolone is injected into the
muscle or fat and not directly administered into the mouth. They are also known by their
chemical name that is 19-nortestosterone as they belong to the class of anabolic steroids
whose biological target is testosterone (Wood & Stanton, 2012). Nandrolone is known to
show high ratio of anabolic activity to androgenic activity. The esters of the Nandrolone has
shown many chemical uses like in ophthalmic solution or in cancer (Guimarães et al, 2017).
Nandrolone decanoate is known to manage anaemia and has shown increase in red cells mass
and haemoglobin. When observed with virilisation and signs of deepened voice it should be
discontinued to prevent irreversible virilisation. In case of drug interactions as Nandrolone
may increase its sensitivity to anticoagulants. Nandrolone works by entering the cell and bind
by activating specific nuclear and androgenic receptors. The pharmacological management of
Nandrolone helps to control a specific medical condition. For the desired pharmacological
management and achieve quality outcome, it is required to understand the drug interactions
and possible side effects (Jogerst, et al, 2016).
Androlone is an anabolic sterios that occurs naturally in the human body, in less
quantities. It increases production and excretion of erythropoietin by urination. It is also
reported to have a direct action on bone marrow. Nandrolone functions by binding to the
androgen receptor to a much higher degree than testosterone, but because of its incapability
to act on the muscle in a way unmediated by the receptor, and has a lesser amount of overall
effect on the growth of muscle (Drugbank.ca, 2019).
Nandrolone functions by binding to the receptor agonist complexes that directs it for
entering to the nucleus and bind to specific nucleotide sequences of the chromosomal DNA.
The binding areas are called hormone response elements that influences the transcriptional
activity of some genes by producing androgen effects (Drugbank.ca, 2019).

2PHARMACOLOGICAL MANAGEMENT OF NANDROLONE
Anabolic steroids like Nandrolone also help in treatment of cachexia which is a
chronic disease. It is also used for the management of anaemia caused by kidney failure
(Horstman et al, 2018). Nandrolone phenyl propionate is used in treatment of breast cancer.
Patient administered with Nandrolone has shown characteristics of increased body mass.
The outcomes of pharmacological treatment using Nandrolone can be analysed by
using results in clinical results. In menopausal women, the clinical efficacy of Nandrolone
can be addressed by addressing the efficacy of the steroid to manage anaemia and
osteoporosis. The pharmacological management results in the efficient management of
anaemia and osteoporosis in menopausal women. (Drugbank.ca, 2019).
Appropriate management in dosage of the drug is important for efficient outcome in
managing the medical condition (Jogerst, et al, 2016). Nandrolone is also known to be abused
by sportsperson as the testosterone gives increased strength also known as doping (Wood &
Stanton, 2012). High dose of nandrolone may pose severe side effects like erectile
dysfunction in males and cardiovascular damage (Toxnet.nlm.nih.gov, 2019). In contrast with
non-pharmacological treatments, pharmacological treatments are more efficient and are
evidence based. In menopausal women aged around 50 years old, nandrolone decreases bone
resorption and increases the mass of the muscles. Thus, the mechanism allows to conserve the
bone which otherwise get degraded. Nandrolone works by increasing the mineral content in
the bone at the proximal, distal radius and at the lumbar spine. Nandrolone aids in decreasing
the vertebral pain by increasing the balance of calcium and mass muscle. With usage the
mobility of the spine is increased. Patients suffering from corticosteroid induced osteoporosis
may also be treated by administration of nandrolone. The therapeutic profile inhibits bone
resorption capacity and aids in temporary increase in formation of bone. Recent studies have
shown to increase bone density in forearm in patient with osteoporosis (Solbach, 2016).
Conventional therapy for treatment of osteoporosis results only in delay of bone loss but

3PHARMACOLOGICAL MANAGEMENT OF NANDROLONE
nandrolone helps in secondary inhibition of bone formation that result in conserving the bone
mass and increase bone formation (Bhutani & Gupta, 2013).
Healthcare professionals faces ethical considerations while dealing with patients who
are being recovered from anabolic androgenic steroid use and the related conditions (Yu,
Hildebrandt & Lanzieri, 2015). However, The American Medical Association banned the
excessive use of anabolic steroids and other related hormonal derivatives (Hoffmann &
Ratamess, 2006).
Nandrolone belongs medicine called anabolic steroids that increases the sensitivity to
anticoagulants. Patients who are receiving oral therapy of anticoagulants must be monitored
properly particularly during the commencement or termination of anabolic steroids. Dosage
are controlled and decreased for maintaining the prothombin time at the required therapeutic
level. The risk developing edema increases when Nandrolone decanoate is given in
combination with Aldosterone. When given with Albiglutide, Nandrolone can increase its
hypoglycaemic activity. Nandrolone decanoate can also increase the hypoglycemic activity of
Acetohexamide. If Nandrolone is give in combination with Almotriptan, the metabolism of
the drug may get decreased (Drugbank.ca, 2019).
Health professionals are needed to be aware of the mode of action of Nandrolone to
make the treatment effective. Nandrolone being an anabolic steroid has been often misused in
the form of doping, therefore health professionals must make sure that it is not over dosed by
the patients. Clinical information of Nandrolone is vital for the health professionals for
analysing the result of the pharmacological management. Data management and informatics
collaboration are emerging roles for the health professionals for efficient pharmacological
management. Health professionals like nurses, pharmacists and physicians understands the
vital signs of clinical outcome (Wu & Kovac, 2016). Anabolic Androgenic Steroids (AAS) is

4PHARMACOLOGICAL MANAGEMENT OF NANDROLONE
a group of synthetic androgen, which can be used both clinically and illicitly, therefore it is
the responsibility of the health professionals to ensure proper implementation and proper
pharmacological management. There is an evoking role of health professionals to keep up
with changing medical standards in the range of task and settings. There must be more
research in pharmacological management of nandrolone and minimising the adverse effects
in efficient management of the clinical condition. Health professionals play exclusive and
active role as research experts in coping with latest medical standards (Wu & Kovac, 2016).
Inter professional communication and collaboration among health professionals is
very important in pharmacological management to ensure clinical safety. Nandrolone is an
anabolic steroid, which has both illicit and clinical use, so with proper communication among
the health professional is needed to minimise the adverse use. In case of anaemia and
osteoporosis, the knowledge of mode of action of Nandrolone is necessary for the health
professionals to intervene in decision making. Health professional must play an
interdisciplinary role in carrying out care plan for the patient (Bookey‐Bassett et al., 2017).
Unwanted effects like adverse events due to medical error can be minimised by
interdisciplinary approach by the health professionals collaboratively (Bookey‐Bassett et al.,
2017).
Effective communication among the health professional has various positive
outcomes like improved information flow, enhanced intervention and improvement in
patients safety. The coordination of care can be achieved across the continuum of health care
settings. It is important for clinicians to have standardised communication skills as medical
care is related to complex procedures with inherent limitations (Jogerst et al., 2015). This
purpose can be served by efficient communication techniques that can ensure accuracy.
Adoption of standardised strategies are effective in enhancing teamwork that decreases the
risk factors associated with clinical management. Inter professional communication is an

5PHARMACOLOGICAL MANAGEMENT OF NANDROLONE
efficient way of management of adverse effects in health care and is important for achieving
goals in efficient analysing the details of nandrolone management in giving care to the
osteoporosis and anaemia patient (Jogerst et al., 2015).
To summarise the main points of the essay it can be said that Nandrolone is an
efficient drug for the management of anaemia and osteoporosis particularly in menopausal
women. Nandrolone is an anabolic steroid and has other clinical uses like in breast cancer. It
has been also been misused for its use as doping as it is known to increase masculine
character and stamina. The health professionals must ensure that the uses of nandrolone is not
misused and clinical safety is ensured (Wilson et al., 2016). The occurrence of clinical side
effects can be minimised by prescribing to aged menopausal women more than 50 years old.
The side effects are important drug factors that must be controlled by health professionals.
Nandrolone decanoate influences the catabolic metabolism of calcium by renal tubular
reabsorption. Allied health professionals are needed to counsel the patients regarding the
adverse effects of steroids that can be life threatening. Common side effects shown by
nandrolone include breast tenderness, masculinization and increased bladder contractions.
Contraindications for Nandrolone include breastfeeding, pregnancy, male patients with
carcinoma of breasts or prostate and women diagnosed with breast cancer (Drugbank.ca,
2019).
Implementation of standard procedures of behavioural policies are vital for better
outcome in health care. With proper management tools and care plan strategies
collaboratively taken among health professionals, better outcome of pharmacological
management can be achieved. The purpose of inter professional collaboration is to reduce
adverse effects or medical errors and improve the quality of health care (Health.vic.gov,
2019).

6PHARMACOLOGICAL MANAGEMENT OF NANDROLONE
Contraindications for Nandrolone include breastfeeding, pregnancy, male patients
who are having carcinoma of the breast or are diagnosed with carcinoma of the prostate,
woman patients detected with breast cancer with hypercalcemia and hypersensitivity. A high
dosage is also considered to be contraindicated in women because of a high possibility for
virilisation. For the patients suffering from Nephrosis or nephrotic phase of nephritis,
Nandrolone is considered to be contraindicatory (Pubchem.ncbi.nlm.nih.gov, 2019).
Nandrolone is used in the United States for treating anaemia and chronic kidney
disease. It is also used for the treatment of osteoporosis in the post-menopausal women in the
United Kingdom. In Australia, it is used for the treatment of chronic kidney disease, kidney
failure, aplastic anaemia, anaemia of kidney failure, osteoporosis and for the patients who are
on long term corticosteroid therapy (Hoffman & Ratamess, 2006).

7PHARMACOLOGICAL MANAGEMENT OF NANDROLONE
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