Aralin 1Mga limitasyon ng ebidensya at kawalang-katiyakan: pagtugon sa mababang kalidad/biased na pag-aaral at komunikasyon ng clinician sa mga pasyenteTinatalakay ang mga limitasyon ng umiiral na pananaliksik sa anaboliko, kabilang ang selection bias, underreporting, at confounding. Tinuturuan ang mga clinician na bigyang-interpreta ang mahinang o magkaagawang data, magkomunika ng kawalang-katiyakan, at suportahan ang informed, values-based na desisyon ng pasyente.
Karaniwang biases sa anabolic researchPag-interpreta ng observational at case dataPaghawak ng magkaagawang o wala nang ebidensyaPagpaliwanag ng kawalang-katiyakan sa mga pasyenteShared decision-making sa ilalim ng ambiguityPag-dokumento ng risk discussions nang malinawAralin 2Mga acute at subacute adverse effects: polycythemia, hypertension, acne, mood/behavior changes, hepatic injury (oral agents), injection complicationsNaglalahad ng karaniwang maagang adverse effects ng paggamit ng anaboliko, kabilang ang polycythemia, hypertension, acne, mood shifts, hepatic injury mula sa oral agents, at injection complications. Nagbibigay ng practical algorithms para sa detection, grading, at management.
Polycythemia detection at managementBlood pressure elevation at treatmentDermatologic effects at acne careHepatic injury mula sa oral agentsInjection-site at infectious issuesKapag kailangan ng cessation ang acute effectsAralin 3Mga panganib sa cardiovascular: dyslipidemia, myocardial hypertrophy, thrombosis, arrhythmia risk at available evidenceNag-eeksplora kung paano nakakaapekto ang mga anaboliko na ahente sa lipids, blood pressure, myocardium, at coagulation. Nagre-review ng human at animal data sa atherosclerosis, arrhythmias, at sudden death, at nagpapaliwanag kung paano i-stratify at mabawasan ang cardiovascular risk sa mga gumagamit.
Mechanisms ng dyslipidemia at hypertensionMyocardial hypertrophy at remodelingThrombosis at coagulation abnormalitiesArrhythmias at sudden cardiac death riskImaging at functional cardiac assessmentRisk stratification at mitigation stepsAralin 4Mga psychiatric at neurobehavioral effects: aggression, mood disorders, dependence, at withdrawal syndromesTinutukan ang aggression, irritability, depression, anxiety, at suicidality na nauugnay sa paggamit ng anaboliko. Nagdedetalye ng dependence, compulsive cycling, at withdrawal syndromes, at naglalahad ng assessment, safety planning, at referral sa mental health services.
Aggression, irritability, at violence riskMood disorders at suicidalityCognitive at impulse-control changesDependence, craving, at compulsive useWithdrawal syndromes at taperingCollaboration sa mental health servicesAralin 5Mga prinsipyo ng harm reduction kapag inihayag ang non-medical use: pagbabawas ng acute harms, infection prevention, safer dosing concepts, at kapag tatanggihan ang resetaNag-aaplay ng harm reduction kapag inihayag ang non-medical use, na nakatuon sa nonjudgmental engagement, safer dosing concepts, infection prevention, at realistic goal setting. Nililinaw ang legal, ethical, at klinikal na hangganan para sa pagtanggi ng reseta.
Nonjudgmental assessment at rapportSafer dosing at cycle design conceptsInjection hygiene at infection preventionOverdose at acute crisis planningKapag tatanggihan ang prescribing o supportReferral pathways at community resourcesAralin 6Mga ongoing monitoring protocols: frequency at thresholds para sa intervention, red flags para sa urgent cessation at referralNagdedepina ng structured follow-up para sa mga gumagamit ng anaboliko, kabilang ang visit timing, lab at imaging intervals, at thresholds na nagti-trigger ng dose changes, cessation, o referral. Binibigyang-diin ang pagkilala sa red flags at pag-dokumento ng shared decisions.
Visit frequency by risk categoryRoutine lab at imaging intervalsAction thresholds para sa key lab changesClinical signs na nangangailangan ng urgent cessationCriteria para sa specialist referralDocumentation at follow-up planningAralin 7Mga reproductive at endocrine sequelae: hypogonadism, testicular atrophy, infertility, menstrual disturbances, virilization sa femalesNagre-review kung paano nakagugulo ang paggamit ng anaboliko sa hypothalamic-pituitary-gonadal axis, na nagdudulot ng hypogonadism, testicular atrophy, infertility, at menstrual changes. Tumatugon sa virilization sa females at naglalahad ng evaluation, counseling, at recovery expectations.
HPG axis suppression mechanismsMale hypogonadism at testicular atrophyMale at female fertility impairmentMenstrual disruption sa female usersVirilization signs at reversibilityEndocrine recovery at PCT limitsAralin 8Mga musculoskeletal at metabolic harms: tendon injury risk, insulin resistance, at body composition changes sa paglipas ng panahonNag-aaralan ang mga musculoskeletal at metabolic harms, kabilang ang tendon injury, altered collagen, insulin resistance, dysglycemia, at pangmatagalang body composition changes. Naglalarawan ng screening, counseling sa training loads, at strategies upang bawasan ang risk.
Tendon structure at rupture riskJoint stress at injury patternsInsulin resistance at glucose controlVisceral fat at body composition shiftsScreening para sa metabolic syndromeTraining at rehab modificationsAralin 9Screening at baseline evaluation upang mabawasan ang risk: CBC, CMP/LFTs, lipid panel, testosterone/hormone profile, PSA, ECG, blood pressure at targeted imaging kapag inirerekomendaNagdedetalye ng baseline history, physical exam, at targeted testing bago o sa panahon ng anabolic exposure. Nagpapaliwanag kung paano gabayan ng CBC, CMP, lipids, hormones, PSA, ECG, blood pressure, at imaging ang risk stratification at individualized monitoring plans.
Key history at physical exam elementsCBC at CMP/LFT interpretationLipid panel at cardiovascular markersHormone profile, PSA, at gonadal testsECG, blood pressure, at ambulatory dataKapag o-orderin ang echocardiogram o imaging
