Nandrolone Decanoate

INTRODUCTION

Indications

Treatment of anemia associated with renal insufficiency.

Action

Stimulates erythropoietin production and may have a direct stimulant action on bone marrow. Therapeutic Effects: Increased hemoglobin and RBC volume.

Adverse Reactions/Side Effects

CNS: insomnia. CV: edema. GI: abdominal fullness, diarrhea, hepatic dysfunction. GU: changes in libido, erectile dysfunction, prostatic hyperplasia. Derm: acne. Endo: virilism in women and prepubertal men. F and E: hypercalcemia. MS: muscle cramps. Misc: chills.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Watch for signs of hepatic dysfunction, including anorexia, abdominal pain, severe nausea and vomiting, yellow skin or eyes, fever, sore throat, malaise, weakness, facial edema, lethargy, and unusual bleeding or bruising. Report these signs to the physician.

• Measure blood pressure periodically and compare to normal values (See Appendix F). Report a sustained increase in blood pressure (hypertension) to the physician.

• Assess peripheral edema using girth measurements, volume displacement, and measurement of pitting edema (See Appendix N). Report increased swelling in feet and ankles or a sudden increase in body weight due to fluid retention.

• Report signs of high calcium levels, including muscle pain, cramps, weakness, joint pain, confusion, and lethargy.

• Periodically assess body weight and other anthropometric measures (body mass index, body composition). A rapid or unexplained weight gain or increase in muscle mass may indicate androgen abuse.

• Monitor personality changes, including irritability and increased aggression. Aggressive behaviors (“roid rage”) may indicate inappropriate or excessive androgen use.

• Monitor IM injection site for pain, swelling, and irritation. Report prolonged or excessive injection site reactions to the physician.

Interventions

• Design and implement aerobic exercise programs as tolerated to capitalize on increased RBC production and help improve cardiovascular fitness and oxygen delivery to tissues.

• Do not apply physical agents (heat, cold, electrotherapeutic modalities) or massage over the injection site; these interventions can alter drug absorption from subcutaneous tissues.

Patient/Client-Related Instruction

• Advise patient against use of nandrolone and other androgens to artificially increase muscle mass and enhance athletic performance. Androgen abuse is not safe and can cause liver damage, cardiovascular disease, and other serious side effects.

• Advise men about the risk of sexual side effect, including erectile dysfunction and changes in libido. Notify physician if these side effects become persistent or troublesome.

• Instruct men to report signs of prostate enlargement, including difficulty urinating and increased urge to urinate.

• Advise women that masculine side effects are likely, including deepening of voice, unusual hair growth, clitoral enlargement, and menstrual irregularities.

• Instruct patient to report other troublesome side effects such as severe or prolonged sleep loss, ...