Anabolic steroids clinical application

Shahidi NT. A review of the chemistry, biological action, and clinical applications of anabolic-androgenic steroids. Clin Ther. 2001 23 1355-1390. 

Chemical modifications of testosterone have led to some synthetic compounds which show a satisfactory dissociation between anabolic and androgenic properties. Many attempts have also been made to find orally active anabolic steroids without androgenic activity since orally active compounds would have a much greater clinical application than intramuscularly administered drugs. 

Excellent accounts of the biological effects and clinical application of anabolic steroids, by Kriiskemper [5], and of the pharmacology of anabolic steroids, by Overbeek [50], are available. It is the aim of this book to examine the chemical structure-biological activity relationship of androgens and anabolic agents. A new theory of steroid-receptor interaction is also advanced, based on a new approach to the chemical structure-biological activity relationship. 

In a personal communication to the present writer, Harkness (H5) pointed out that a number of steroid drugs with hydrocarbon skeletons which are not found in the naturally occurring steroids have been reduced and the products separated by GLC (A3). One application of such a technique in clinical chemistry is the detection of steroid drugs which in vivo are completely altered metabolically without changing their carbon skeletons. For example, after the administration to normal men of therapeutic doses of the anabolic steroid 17a-methyl-17 8-hydroxyan-drosta-l,4-dien-3-one (Dianabol Ciba) none of the imaltered drug could be detected in urine. A further difiBculty in detecting their administration... 

A ndrogenic and anabolic steroidal hormones present a complex problem of assessment. Their biology, their clinical applications, and the synthetic routes to the best known agents are considered here. 

Many attempts have been made to find orally active steroids which will also have substantially preferential anabolic or androgenic activity. Such compounds would have much greater clinical applicability than the natural steroids. 

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