Common steroid structures

Cells of the zona fasciculata and zona reticularis lack aldosterone synthase (CYP11B2) that converts corticosterone to aldosterone, and thus these tissues produce only the weak mineralocorticoid corticosterone. However, both these zones do contain the CYP17A1 missing in zona glomerulosa and thus produce the major glucocorticoid, cortisol. Zona fasciculata and zona reticularis cells also contain CYP17A1, whose 17,20-lyase activity is responsible for producing the androgens, dehydroepiandosterone (DHEA) and androstenedione. Thus, fasciculata and reticularis cells can make corticosteroids and the adrenal androgens, but not aldosterone.

The most commonly used AAS in medicine are testosterone and its various esters (but most commonly testosterone undecanoate , testosterone enanthate , testosterone cypionate , and testosterone propionate ), [53] nandrolone esters (most commonly nandrolone decanoate and nandrolone phenylpropionate ), stanozolol , and metandienone (methandrostenolone). [1] Others also available and used commonly but to a lesser extent include methyltestosterone , oxandrolone , mesterolone , and oxymetholone , as well as drostanolone propionate , metenolone (methylandrostenolone), and fluoxymesterone . [1] Dihydrotestosterone (DHT; androstanolone, stanolone) and its esters are also notable, although they are not widely used in medicine. [54] Boldenone undecylenate and trenbolone acetate are used in veterinary medicine . [1]

If there is no improvement within 12 to 24 hours, surgical intervention is warranted. Early surgical treatment should be considered if the patient is immunocompromised or has diabetes. 24 Surgical treatment involves proximal and distal tendon exposure, and careful insertion of a catheter or feeding tube into the tendon sheath with copious intraoperative irrigation. 1 , 4 , 15 , 24 , 25 Postoperatively, the catheter may be left in place for 24 hours to allow for further low-flow irrigation. One retrospective study 29 questioned the utility of postoperative irrigation and found no difference in outcome whether the catheter was left in or taken out. Parenteral antibiotic therapy should be continued for at least 48 hours. Comparable oral antibiotic therapy should then be instituted and continued for an additional five to 14 days on an outpatient basis. Physical and occupational therapy should be initiated to reduce long-term disability from scarring and contractures.

Common steroid structures

common steroid structures

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