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Resistance to ketoconazole has been observed in a number of clinical fungal isolates, including Candida albicans . Experimentally, resistance usually arises as a result of mutations in the sterol biosynthesis pathway. Defects in the sterol 5-6 desaturase enzyme reduce the toxic effects of azole inhibition of the 14-alpha demethylation step. Multidrug-resistance (MDR) genes can also play a role in reducing cellular levels of the drug. As azole antifungals all act at the same point in the sterol pathway, resistant isolates are normally cross-resistant to all members of the azole family. [36] [37]

Injectable steroids are injected into muscle tissue, not into the veins. They are slowly released from the muscles into the rest of the body, and may be detectable for months after last use. Injectable steroids can be oil-based or water-based. Injectable anabolic steroids which are oil-based have longer half-life than water-based steroids. Both steroid types have much longer half-lives than oral anabolic steroids. And this is proving to be a drawback for injectables as they have high probability of being detected in drug screening since their clearance times tend to be longer than orals. Athletes resolve this problem by using injectable testosterone early in the cycle then switch to orals when approaching the end of the cycle and drug testing is imminent.

The original brand name of oxandrolone was Anavar, which was marketed in the United States and the Netherlands . [4] [33] This product was eventually discontinued and replaced in the United States with a new product named Oxandrin, which is the sole remaining brand name for oxandrolone in the United States. [4] [34] Oxandrolone has also been sold under the brand names Antitriol ( Spain ), Anatrophill ( France ), Lipidex ( Brazil ), Lonavar ( Argentina , Australia , Italy ), Protivar, and Vasorome ( Japan ) among others. [4] [27] [33] [35] Additional brand names exist for products that are manufactured for the steroid black market. [4]

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