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Cyproterone is used to control sexual attraction in men in cases of sexual deviations, as well as for inoperable prostate gland carcinoma. In women, it is used for severe cases of androgenization, and in children with idiopathic premature sexual maturity. Synonyms of this drug are cyprostat, androcur, daian, and others.

Flutamide: Flutamide, 4'-nitro-3'-trifluoromethylisobutyranilide (29.2.15), a nonsteroid antagonist of androgens, is made by acylating 4-nitro-3-trifluoromethylaniline with isobu-tyric acid chloride [13-15].

F3C F3C 29.2.15

Flutamide is a nonsteroid drug that possesses antiandrogenic action. It blocks androgens from binding with target tissues, thus preventing androgen action. The mechanism of action is possibly also linked with a halt in dihydrotestosterone transport. It facilitates a reduction in size and density of the prostate gland, and it reduces the amount of metastases in such cancer, for which it is used in palliative treatment of prostate gland cancer. Synonyms of this drug are fugerel, eulexin, and others.

In searching for new androgenic compounds, substances very similar in structure to testosterone were made that have more pronounced, and even selective anabolic activity. Their most characteristic property is the ability to stimulate protein synthesis in the body, increase nitrogen exchange, slow down removal of nitrogen, phosphorous, potassium, and calcium from the body, which results in increased muscle mass, development of osseous tissue, the general condition of the body, and increased appetite. Anabolic steroids are used for cachexy, asthenia, after radiation therapy, osteoporosis, and for stimulating the regeneration processes.

Nandrolone: Nandrolone, 17/-hydroxyester-4-en-3-one (29.1.7), is made from estradiol (28.1.17). The phenol hydroxyl group undergoes methylation by dimethylsulfate in the presence of sodium hydroxide, forming the corresponding methyl ether (29.3.1), and then the aromatic ring is reduced by lithium in liquid ammonia, which forms an enol ether (29.3.2). Hydrolyzing this compound with a mixture of hydrochloric and acetic acids leads to the formation of a keto group, and simultaneous isomerization of the double bond from C5-C10 to position C4-C5 gives the desired nandrolone (29.3.3) [16-19]. Upon necessity of using it in the form of acid esters, the product is acylated by corresponding acid derivatives [20].

Nandrolone facilitates formation of body muscle mass and strengthens the process of osseous tissue development. The main indications for using nandrolone, as well as other anabolic steroids, are abnormal protein anabolism, asthenia, diseases accompanied by protein loss, adrenal insufficiency, steroid diabetes, and prolonged condition of sluggishness. Synonyms of this drug used in the form of acid esters are retabolil, fenobolin, eubolin, and many others.

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