Showing posts with label kidney. Show all posts
Showing posts with label kidney. Show all posts

Thursday, January 22, 2009

A New Book on the Medical Use of Anabolic Steroids


A New Book on the Medical Use of Anabolic Steroids

Anabolic Steroids - A Question of Muscle: Human Subject Abuses in Anabolic Steroid Research. By Dr Michael Scally


Available at Amazon.com

http://www.amazon.com/Anabolic-Steroids-Question-Subject-Research/dp/096622311X/ref=sr_1_1?ie=UTF8&s=books&qid=1232669135&sr=1-1


My review:

Along with Michael Mooney, I am the co-author of the book "Built to Survive: a comprehensive guide to the medical use of anabolic therapies, nutrition and exercise for HIV+ men and women." I am very happy to see that Dr Scally spent months of work researching the effects of anabolics on the Hypothalamic Pituitary Testicular Axis (HPTA)and how these compounds can cause long term hypogonadism (low testosterone) if not used properly.
Most doctors in clinical practice are not trained on how to avoid hypogonadism after anabolic steroid use for medical and non medical purposes. We have used them with great results them for HIV wasting for many years using good physician monitoring. Hopefully, this book will make it possible for clinicians to learn the main issues surrounding the proper use of these life-saving compounds.

I am so glad that Dr Scally wrote a simple explanation on a protocol that may help reset our body's own hormonal axis to prevent the debilitating effects of "post-steroid crashing." There are no published data on the subject, so this book is groundbreaking.

Dr Scally reviews data on the use of anabolic steroids for the following medical uses:

- To treat wasting syndrome related to the Human Immunodeficiency Virus (HIV),
- To treat strength and weight loss associated with Chronic Obstructive Pulmonary Disease (COPD) and Chronic Kidney Disease/Hemodialysis
- To counteract osteoporosis and the negative effects of glucocorticoids on bone density and lean body mass,
- To reverse and prevent the age-related loss of lean body mass (Sarcopenia.)

For physicians and lay people who love to read easy-to-understand clinical information, this book is for you. Every man using testosterone or anabolic steroids should do their research to avoid the most common and untreated side effect caused with the use of these compounds. When used correctly with solid research data and monitoring, anabolics can be great to improve quality of life and lean tissue in people suffering from many debilitating conditions. However, most of the benefits disappear after their use is stopped and quality of life tends to worsen unless an effective HPTA reset protocol is used. This book explains such approach.

Nelson Vergel

Monday, August 25, 2008

Tenofovir Dosing for patients with kidney dysfunction


I have seen some confusion about Tenofovir (Viread, which is in Truvada and Atripla) dosing in those with kidney problems in my pozhealth at yahoogroups.com list, so I am posting this information.

So far, most of the problems with tenofovir and kidney function have been reported in treatment experienced patients on boosted protease inhibitors, african americans, people with diabetes, or those using other medications that may affect the kidneys. Naive patients on Atripla seem to be doing just fine.

By the way, for those of you who have not calculated your creatinine clearance, ask your doctor if that value is included in your lab report. If not , ask him or her to include it. You can also calculate it here:

http://cpsc.acponline.org/enhancements/212creatinineCalc.html


From
http://www.medscape.com/druginfo/monograph?cid=med&drugid=22106&drugname=Viread+Oral&monotype=monograph&secid=3


Special Populations
Dosage of tenofovir should be adjusted in adults with creatinine clearances less than 50 mL/minute. The manufacturer and some experts recommend that adults with creatinine clearances of 30 to 49 mL/minute should receive 300 mg of tenofovir once every 48 hours and those with clearances of 10 to 29 mL/minute should receive 300 mg twice weekly. Adults undergoing hemodialysis should receive 300 mg of tenofovir once every 7 days (based on 3 hemodialysis sessions per week, each lasting approximately 4 hours) or 300 mg after a total of approximately 12 hours of dialysis; the dose should be administered following completion of a dialysis session. Because safety and efficacy of these dosages have not been evaluated in clinical studies, clinical response to treatment and renal function should be closely monitored. The manufacturer states that dosage recommendations cannot be made for adults with creatinine clearances less than 10 mL/minute who are not undergoing hemodialysis since the pharmacokinetics of the drug have not been studied in such patients.
The usual dosage of the fixed-combination preparation containing emtricitabine and tenofovir disoproxil fumarate (Truvada®) can be used in adults with creatinine clearances of 50 mL/minute or greater. The manufacturer of the fixed-combination preparation recommends a dosage of one tablet (200 mg of emtricitabine and 300 mg of tenofovir disoproxil fumarate) every 48 hours in adults with creatinine clearances of 30–49 mL/minute; response to therapy and renal function should be monitored in these patients since this dosing recommendation has not been evaluated in clinical studies. The fixed-combination preparation should not be used in adults with creatinine clearances less than 30 mL/minute, including those undergoing dialysis.

The usual dosage of the fixed-combination preparation containing tenofovir disoproxil fumarate, emtricitabine, and efavirenz (Atripla®) can be used in adults with creatinine clearances of 50 mL/minute or greater. The fixed-combination preparation should not be used in adults with creatinine clearances less than 50 mL/minute.

Dosage adjustment is not necessary in patients with hepatic impairment

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