Testosterone Cypionate

INTRODUCTION

Indications

Hypogonadism in androgen-deficient men.

Action

Responsible for the normal growth and development of male sex organs. Maintenance of male secondary sex characteristics: Growth and maturation of the prostate, seminal vesicles, penis, scrotum; Development of male hair distribution; Vocal cord thickening; Alterations in body musculature and fat distribution. Therapeutic Effects: Correction of hormone deficiency in male hypogonadism.

Adverse Reactions/Side Effects

EENT: deepening of voice. CV: edema. GI: cholestatic jaundice, drug-induced hepatitis, liver function test elevation, nausea, vomiting. GU: change in libido, erectile dysfunction, priapism, prostatic enlargement. Endo: gynecomastia, hirsutism, oligospermia, hypercholesterolemia. F and E: hypercalcemia, hyperkalemia, hyperphosphatemia. Derm: male pattern baldness. Local: pain at injection site.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Watch for signs of hepatoxicity and drug-induced hepatitis, 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.

• 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.

• Monitor signs of electrolyte imbalances, including high plasma potassium levels (bradycardia, fatigue, weakness, numbness, tingling), high calcium levels (muscle pain and weakness, joint pain, confusion, lethargy), or high phosphate levels (ectopic calcification). Notify physician because severe cases can lead to life-threatening arrhythmias and paralysis.

• 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 resistive exercise programs to capitalize on androgen effects and increase muscle strength in androgen-deficient men.

• 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 testosterone 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 patient about risk of breast enlargement, persistent erections, erectile dysfunction, changes in libido, and other masculinization effects (male pattern baldness, increased body hair, deepening voice). Notify physician if these side effects become persistent or troublesome.

• Instruct ...