Transcript Ergogenic Drug Use

Ergogenic Drug Use
Jon Fravel, MS, ATC
Recent Cases
• Jessica Hardy- Swimmer1
– US Olympic Trials
– July 1 (Negative) Following 100 Breast
– July 4 (Positive)
– July 6 (Negative)
• Clenbuterol
Clenbuterol
• Bronchodilator/Anabolic Agent
– Longlasting
– Domestic Rx equine use for airway obstruction
– Abroad on humans
• Bronchodilation/Asthmatics
– Reasons for abuse
• Anabolic effect
• Weightloss
– Bodybuilders
– Weightloss Supplement of the Stars!
» Lindsay Lohan
Recent Cases
• Đỗ Thị Ngân Thương –Vietnamese Gymnast
– Olympic Games
– Furosemide
• IOC
Furosemide
• Loop Diuretic (Lasix)
– Congestive Heart failure
– Edema
• WADA Banned Substance
– Masking agent
• Reasons for Abuse
– Masking agent
– Weight loss
Recent Cases
• NFL
– Minnesota Vikings/New Orleans Saints
– Banned Diuretic
• Star Cap
– Bumetanide
Bumetanide (Bumex)
• Loop Diuretic
– Heart failure
• Reason for Abuse
– Weight loss
– Masking agent
History
• Long history of performance-enhancing drugs
(PED)
– Greek/Ancient Olympics
– Roman Gladiators
– IOC in the 1960’s
– World Anti-Doping Agency (1999)
History of PED’s
• 1. Modern Olympic Games-1970’s
– Administration immediately prior/during
competition
• Stimulants
• Narcotics
• Drugs of Abuse
History of PED’s
• 2. Repeated administration over a period of
time.
– Anabolic Steroids
History of PED’s
• 3. Pharmaceutical development/involvement
of protein chemistry, moelcular biology, and
genetic engineering.
– Peptide Hormones
• EPO
• Growth Hormone
• Gonadotropins
History of PED’s
• 4? Gene doping via gene therapy.
Level The Playing Field
• Republica Socialistă România
– Swimming
Clinical Trials
• Phase I Clinical trials
– Activity
– Dosage range
– Side Effects
• Phase II Clinical Trials
– Efficacy
– Evaluate Safety
• Phase III
– Confirm Evidence
– Monitor Side Effects
Side Effects
• Off-Label Drugs
– Except Designer Steroids
• Overdosing
– Acute/Chronic
• Drug/Drug Interaction
– Parallel administration for combined therapeutic
schemes
WADA Anti-Doping Code
2008 “Prohibited List”
• S1. Anabolic Agents
– 1. Anabolic androgenic steroids
• a. Exogenous Anabolic androgenic steroids
• b. Endogenous anabolic androgenic steroids
– 2. Other anabolic agents
• Clenbuterol and selective androgen receptor
modulators)
Substances
• S2. Hormones and related substances
– EPO
– HGH
– Insulin-like growth factors
– Gonadotropins
– Insulin
Substances
• S3. β2 Agonists
– Salbutamol, salmeterol, formoterol, clenbuterol,
etc.
Substances
• S4. Hormone antagonists and modulators
– Antiestrogens
– Myostatin inhibitors
Substances
• S5. Diuretics and other masking agents
– Diuretics
– Epitestosterone
– Probenecid
– α-reductase inhibitors
– Plasma expanders
Prohibited Methods
• M1. Enhancement of oxygen transfers
– Blood transfusions
– Blood derivatives/analogs
Methods
• M2. Chemical and Physical Manipulation
– Physical tampering
– IV infusions
Methods
• M3. Gene Doping
– “Non-therapeutic use of cells, genes, genetic
elements, or modulation of gene expression,
having the capacity to improve athletic
performance” (WADA)
Substances and Methods
Prohibited in Competition
• S6. Stimulants
– Amphetamine, cocaine, etc
• S7. Narcotics
– Morphine, opioids
• S8. Cannabinoids
– Hashish, marijuana
• S9. Gluccocorticosteroids
Substances Prohibited in Particular
Sports
• P1. Alcohol
• P2. β-Blockers
Olympic Motto
• "Citius, Altius, Fortius”
– Faster, Higher, Stronger
• Olympic Creed
– "The most important thing in the Olympic Games
is not to win but to take part, just as the most
important thing in life is not the triumph but the
struggle. The essential thing is not to have
conquered but to have fought well."
References
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"Press Release - Hardy - August 2008", USADA (2008-08-01). Retrieved on 2 August 2008.
Botre, F. Pavan, A. Enhancement Drugs and the Athlete. Neurol Clin 26 (2008) 149–167
Wagner JC. Enhancement of athletic performance with drugs. An overview. Sports Med
1991;12:250–65.
Use of Performance-Enhancing Substances Ped 9/9/05
The World Anti-Doping Code. World anti-doping agency. Montreal (Canada). 2007. Available
at: www.wada-ama.org
NCAA Banned-Drug Classes 2007-08. NCAA. Indianapolis, Indiana. 2008.
Spitzer G. Doping with children. In: Peters C, Schulz T, Michna H, editors. Biochemical side
effects of doping. Ko¨ ln (Germany): Sport ch Strauss; 2001. p. 127–39.
Segura J. Sports. In: Karch SB, editor. Drug abuse handbook. Boca Raton (USA): CRC Press;
1998. p. 641–726.