This is an antibiotic that has figured prominently in recent news items about cases of Duchenne due to premature "stop codons." In these cases the complete gene for dystrophin is never "decoded" or translated so that this critical muscle protein is not made, or at least not made in full form. Research on mdx mice that simulate human Duchenne has shown that when gentamycin is administered, the premature stop codon is somehow ignored so that the entire gene transcript can be "read" and dystrophin can be produced. A preliminary trial on Duchenne young men is underway, and hopes are high that this will work in humans as well as it did in the model mice. Unfortunately, this treatment would only work for those instances (about 10% of all Duchenne cases) in which the gene defect is a premature stop codon.
A reasonable initial panel of tests in the elderly patient with unintentional weight loss includes the following: a fecal occult blood test to screen for cancer; a complete blood count to look for infection, deficiency anemia or lymphoproliferative disorder; a chemistry profile to look for evidence of diabetes mellitus, renal dysfunction or dehydration; an ultrasensitive thyroid-stimulating hormone test to look for hypothyroidism or hyperthyroidism; and a urinalysis to look for evidence of infection, renal dysfunction or dehydration. Upper gastrointestinal studies (radiography or endoscopy) may be warranted in patients with symptoms referable to the gastrointestinal system or in patients with persistent weight loss.
Anticoagulants: Patients on anticoagulants such as warfarin should be carefully monitored during anabolic steroid therapy as anabolic steroids may increase sensitivity to oral anticoagulants which may require a concomitant reduction in anticoagulant dosage to achieve a desirable prothrombin time (PT). Anticoagulant patients should be monitored regularly during anabolic steroid therapy, particularly during initiation and termination of therapy. Warfarin patients should have INR and PT monitored throughout androgen therapy and warfarin dosages titrated to achieve the desired INR and PT. Such patients should be monitored for occult bleeding.