Overview

This is a comprehensive, 100-hour continuing education program designed to strengthen physician associates'/assistants' knowledge and clinical decision-making across a broad range of common and complex conditions affecting adult health. The curriculum integrates evidence-based approaches to cardiovascular and metabolic disease, musculoskeletal and neurologic disorders, behavioral health, pain and substance-related concerns, and ethical and end-of-life care. Topics include heart failure, hypertension, diabetes, overweight and obesity, osteoporosis, back pain, Parkinson disease, behavioral addictions, opioid safety, anabolic steroid use, medical ethics, and counseling patients and families at the end of life. The program also addresses the evidence, safety considerations, and potential drug interactions associated with natural medicines and dietary supplements used for depression, anxiety, and weight loss. Emphasizing whole-person care, this program equips physician assistants to apply current evidence and clinical principles to the assessment, management, counseling, and ongoing care of diverse adult patients.

Education Category: Community Health
Release Date: 09/01/2026
Expiration Date: 08/31/2027

Table of Contents

Audience

This course is designed for physician assistants and interested healthcare professionals.

Accreditations & Approvals

In support of improving patient care, TRC Healthcare/NetCE is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. NetCE is accredited by the International Accreditors for Continuing Education and Training (IACET). NetCE complies with the ANSI/IACET Standard, which is recognized internationally as a standard of excellence in instructional practices. As a result of this accreditation, NetCE is authorized to issue the IACET CEU.

Designations of Credit

NetCE designates this enduring material for a maximum of 100 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. NetCE is authorized by IACET to offer 10 CEU(s) for this program.

Faculty

Patricia Lea, RN, DNP, MSEd, CCRN, received a Bachelor of Science degree in Nursing in 1973 from Houston Baptist University in Houston, Texas. She returned to graduate school to complete a Master’s degree in Education, specifically Health Education, in 1996 from Baylor University in Waco, Texas, and a Doctorate in Nursing Practice in Executive Leadership in 2014 from American Sentinel University in Aurora, Colorado. Dr. Lea specializes in critical care nursing, with an emphasis on heart failure and sepsis. She started her career at the Houston Methodist Hospital in the cardiovascular ICU and opened an acute dialysis unit at what is now Baylor St. Luke’s Medical Center in the Houston Medical Center. Dr. Lea was a Cardiovascular Clinical Coordinator and Director of the Heart Failure Clinic at Hillcrest Baptist Medical Center in Waco, Texas. In 2004, Dr. Lea returned to Houston and was employed as a Senior Research Clinical Nurse Specialist at the Texas Heart Institute coordinating stem cell and cardiac stent trials. She is currently Associate Professor and Baccalaureate Program Director at the University of Texas Medical Branch School of Nursing in Galveston, Texas.

John J. Whyte, MD, MPH, is currently the Chief Medical Officer at WebMD. In this role, he leads efforts to develop and expand strategic partnerships that create meaningful change around important and timely public health issues. Previously, Dr. Whyte was the Direc­tor of Professional Affairs and Stakeholder Engage­ment at the FDA’s Center for Drug Evaluation and Research and the Chief Medical Expert and Vice President, Health and Medical Education at Discovery Channel, part of the media conglomerate Discovery Communications.

Prior to this, Dr. Whyte was in the Immediate Office of the Director at the Agency for Healthcare Research Quality. He served as Medical Advisor/Director of the Council on Private Sector Initiatives to Improve the Safety, Security, and Quality of Healthcare. Prior to this assignment, Dr. Whyte was the Acting Director, Division of Medical Items and Devices in the Coverage and Analysis Group in the Centers for Medicare & Medicaid Services (CMS). CMS is the federal agency responsible for administering the Medicare and Medicaid programs. In his role at CMS, Dr.Whyte made recommendations as to whether or not the Medicare program should pay for certain procedures, equipment, or services. His division was responsible for durable medical equipment, orthotics/prosthetics, drugs/biologics/therapeutics, medical items, laboratory tests, and non-implantable devices. As Division Director as well as Medical Officer/Senior Advisor, Dr. Whyte was responsible for more national coverage decisions than any other CMS staff.

Dr. Whyte is a board-certified internist. He completed an internal medicine residency at Duke University Medical Center as well as earned a Master’s of Public Health (MPH) in Health Policy and Management at Harvard University School of Public Health. Prior to arriving in Washington, Dr. Whyte was a health services research fellow at Stanford and attending physician in the Department of Medicine. He has written extensively in the medical and lay press on health policy issues.

Mark Rose, BS, MA, LP, is a licensed psychologist in the State of Minnesota with a private consulting practice and a medical research analyst with a biomedical communications firm. Earlier healthcare technology assessment work led to medical device and pharmaceutical sector experience in new product development involving cancer ablative devices and pain therapeutics. Along with substantial experience in addiction research, Mr. Rose has contributed to the authorship of numerous papers on CNS, oncology, and other medical disorders. He is the lead author of papers published in peer-reviewed addiction, psychiatry, and pain medicine journals and has written books on prescription opioids and alcoholism published by the Hazelden Foundation. He also serves as an Expert Advisor and Expert Witness to law firms that represent disability claimants or criminal defendants on cases related to chronic pain, psychiatric/substance use disorders, and acute pharmacologic/toxicologic effects. Mr. Rose is on the Board of Directors of the Minneapolis-based International Institute of Anti-Aging Medicine and is a member of several professional organizations.

Chelsey McIntyre, PharmD, is a clinical pharmacist who specializes in drug information, literature analysis, and medical writing. She earned her Bachelor of Science degree in Genetics from the University of California, Davis. She then went on to complete her PharmD at Creighton University, followed by a clinical residency at the Children’s Hospital of Philadelphia (CHOP). Dr. McIntyre held the position of Drug Information and Policy Development Pharmacist at CHOP until her move to Washington state in 2017, after which she spent the next six years as a clinical editor for Natural Medicines, a clinical reference database focused on natural products and alternative therapies. She continues to create rigorous professional analysis and patient education materials for various publications while also practicing as a hospital pharmacist. Her professional interests include provider and patient education, as well as the application of evidence-based research to patient care.

Lisa Hutchison, LMHC, has more than 20 years of experience providing individual and group counseling with adults. She specifically focuses on teaching assertiveness, stress management, and boundary setting for empathic helpers. Ms. Hutchison graduated from the University of Massachusetts, Boston, with a Master’s degree in education for mental health counseling.

John M. Leonard, MD, Professor of Medicine Emeritus, Vanderbilt University School of Medicine, completed his post-graduate clinical training at the Yale and Vanderbilt University Medical Centers before joining the Vanderbilt faculty in 1974. He is a clinician-educator and for many years served as director of residency training and student educational programs for the Vanderbilt University Department of Medicine. Over a career span of 40 years, Dr. Leonard conducted an active practice of general internal medicine and an inpatient consulting practice of infectious diseases.

Faculty Disclosure

Contributing faculty, Patricia Lea, RN, DNP, MSEd, CCRN, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Contributing faculty, John J. Whyte, MD, MPH, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Contributing faculty, Mark Rose, BS, MA, LP, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Contributing faculty, Chelsey McIntyre, PharmD, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Contributing faculty, Lisa Hutchison, LMHC, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Contributing faculty, John M. Leonard, MD, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

Division Planners

John V. Jurica, MD, MPH

John M. Leonard, MD

Division Planners Disclosure

The division planners have disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.

About the Sponsor

The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.

Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.

Technical Requirements

Supported browsers for Windows include Microsoft Internet Explorer 9.0 and up, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Supported browsers for Macintosh include Safari, Mozilla Firefox 3.0 and up, Opera 9.0 and up, and Google Chrome. Other operating systems and browsers that include complete implementations of ECMAScript edition 3 and CSS 2.0 may work, but are not supported. Supported browsers must utilize the TLS encryption protocol v1.1 or v1.2 in order to connect to pages that require a secured HTTPS connection. TLS v1.0 is not supported.

#41970: The Adult Patient: Evidence-Based Care for Mind and Body

Part 5 of 14 · Chapter 1 of 11

Part 5. Medical and Illicit Use of Anabolic Steroids

Course Objective

The purpose of this course is to provide healthcare professionals with the knowledge necessary to recognize and intervene early in order to prevent adverse and potentially irreversible consequences of anabolic-androgenic steroid misuse.

Learning Objectives

Upon completion of this course, you should be able to:

  1. Describe the pharmacology and mechanism of action of anabolic steroids, specifically testosterone.
  2. Outline the range of therapeutic indications of anabolic steroids.
  3. Identify the epidemiology, risk factors, and characteristics of anabolic steroid abusers.
  4. List the potential adverse effects of anabolic steroid use.
  5. Discuss the signs and symptoms of anabolic steroid use and abuse.
  6. Recall appropriate interventions to manage the physical and neuropsychiatric effects of acute and chronic anabolic steroid use in current and past users.

INTRODUCTION

Anabolic steroids, also referred to as anabolic-androgenic steroids (AAS), include the male hormone testosterone and related compounds that have muscle-building (anabolic) and masculinizing (androgenic) effects. Anabolic steroids have gained the attention of the lay public and the medical community due to the proliferation of media attention on their use in professional sports and the growing prevalence among amateur athletes. While most often discussed in terms of illicit use, anabolic steroids are also used to treat a variety of medical conditions. This course will explore the history, pharmacology, and mechanism of action of anabolic steroids and the use of anabolic steroids in three different contexts. These will include the legitimate medical use of testosterone replacement in hypogonadal male patients, the legitimate medical use of anabolic steroids in patients with conditions that benefit from either the anabolic or androgenic properties of these agents, and the illicit use of anabolic-androgenic steroids with the goal of increased muscle mass or cosmetic improvement. For the sake of clarity, the abbreviation AAS will be used when illicit, non-medically supervised use of these drugs is discussed.

Works Cited

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2. Aagaard P. Making muscles "stronger:" exercise, nutrition, drugs. J Musculoskel Neuron Interact. 2004;4(2):165-174.

3. Adachi M, Takayanagi R. Effect of anabolic steroids on osteoporosis. Clin Calcium. 2008;18(10):1451-1459.

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11. Bhasin S, Calof OM, Storer TW, et al. Drug insight: testosterone and selective androgen receptor modulators as anabolic therapies for chronic illness and aging. Nat Clin Pract Endocrinol Metab. 2006;2(3):146-159.

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46. Kanayama G, Barry S, Hudson JI, Pope HG Jr. Body image and attitudes toward male roles in anabolic-androgenic steroid users. Am J Psychiatry. 2006;163:697-703.

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59. Leit RA, Pope HG Jr, Gray JJ. Cultural expectations of muscularity in men: the evolution of Playgirl centerfolds. Int J Eat Disord. 2001;29(1):90-93.

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Part 5 of 14 · Chapter 1 of 11


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