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Pathophysiology & Pharmacology > Performance Enhancing Drugs > Flashcards

Performance Enhancing Drugs Flashcards

1
Q

International Olympic Committee Definition

A
  • Any substance foreign to the body or any physiological substance taken in abnormal quantity or by an abnormal route into the body.
  • Taken for the sole intention of increasing performance in competition.
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2
Q

Stimulants: Amphetamines

A
  • Originally used for the treatment of asthma.
    ~ Used now for ADHD and narcolepsy.
  • Controlled Substances
    ~ Illegal to use or posses without a
    prescription
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3
Q

Stimulants: Amphetamines Mechanism - Binding

A
  • Bind to alpha and beta receptors of the sympathetic nervous system
    ~ Increased Blood Pressure
    ~ Increased Heart Rate
    ~ Increased Heart Contractility
    ~ Increased Respiratory Rate
    ~ Increased Myocardial Conduction
    ~ Bronchodilation
    ~ Increased Metabolic Rate
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4
Q

Stimulants: Amphetamines Mechanism - Increase Release of..

A
  • Increase the release of and decrease reputake of norepinephrine, serotonin, and dopamine
    ~ Further stimulation of alpha and beta
    receptors.
    ~ In the brain:
    > Dopamine and norepinephrine are
    excitatory.
    > Serotonin enhances neuron
    response to dopamine and
    norepinephrine.
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5
Q

Stimulants: Amphetamines Adverse Effects - Minor

A
  • Decreased Appetite
  • Fever
  • Sweating
  • Headache
  • Restlessness
  • Anxiety
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6
Q

Stimulants: Amphetamines Adverse Effects - Major

A
  • Arrhythmia
    ~ Sudden Cardiac Death
  • Stroke
  • Psychosis
  • Predisposed to heat stroke.
  • Dependence
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7
Q

Stimulants: Caffeine

A
  • Banned by the NCAA, but only if levels are over a specific amount (15 micrograms/mL) = 6 cups of coffee before testing
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8
Q

Stimulants: Caffeine Mechanism

A
  • Prevents binding of adenosine to its receptors in the brain
    ~ Adenosine burning causes drowsiness
  • Enhances the effect of Epinephrine
    ~ Increased Blood Pressure
    ~ Increased Heart Rate
    ~ Increased Heart Contractility
    ~ Increased Respiratory Rate
    ~ Increased Myocardial Conduction
    ~ Bronchodilation
    ~ Increased Metabolic Rate
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9
Q

Stimulants: Caffeine Adverse Effects

A
  • Anxiety
  • Jitters
  • Dizziness
  • Headache
  • Diuresis
    ~ Inhibits anti-diuretic hormone (ADH)
    release = pt. pees more
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10
Q

Stimulants: Ephedrine

A
  • Found in the ma-huang plant along with pseudoephedrine.
    ~ Used to treat asthma, nasal
    congestion.
    ~ Led to development of
    amphetamines.
  • Ephedra/ma-huang previously available as an herbal supplement.
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11
Q

Stimulants: Ephedrine Mechanism and Adverse Effects

A

Same as Amphetamines but less magnitude

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12
Q

Anabolic Agents

A
  • Substance that prompts tissue growth
    ~ Mostly used to enhance protein
    synthesis.
    > To increase muscle mass and
    strength.
    > Testosterone or some derivative of
    testosterone typically used.
    • Anabolic-Androgenic Steroids
    (AAS)
  • Good for injuries = healing properties
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13
Q

Anabolic-Androgenic Steroids (AAS): Oral Administration

A
  • Shorter acting
  • Drug is subject to first pass effect
    ~ Sometimes modified (alkalized) to
    prevent breakdown in the liver
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14
Q

Anabolic-Androgenic Steroids (AAS): Parenteral Administration

A
  • Longer acting
  • Sometimes modified into esters
    ~ Prolongs half life
    ~ Less water soluble - less/slower entry
    into circulatory system
  • Injected into muscle
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15
Q

Anabolic-Androgenic Steroids (AAS): Mechanism - Receptors

A
  • AAS receptors found in most cells
    ~ AAS interact with cells DNA casing
    stimulation of messenger RNA and
    production of new protein
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16
Q

Anabolic-Androgenic Steroids (AAS): Effects

A
  • Effect of AAS on cell depends on:
    ~ Location of Cell
    ~ Type of Cell
    ~ Type of steroid-metabolizing enzyme
    in cell.
  • Effects
    ~ Increased Muscle Mass
    ~ Increased Bone Density
    ~ Accelerated Bone Growth
    ~ Increased Heart Size
    ~ Increased Liver Size
    ~ Increased RBC Production
    ~ Enlarged Larynx
17
Q

Muscle Mass Mechanism: Increased Protein Synthesis

A
  • Competes with glucocorticoids for cell receptor sites
    ~ Remember that glucocorticoids
    caused amino acid mobilization for
    conversion to glucose.
    ~ Causes body to store instead of
    mobilize
  • AAS receptor activation in the brain may cause feelings of aggression, euphoria.
    ~ Roid Rage
18
Q

AAS Adverse Effects

A
  • Liver Disease
  • Dyslipidemia: Low HDL and High LDL
  • Hypogonadism
    ~ Small testes
19
Q

Anabolic Agents: Human Growth Hormone (HGH)

A

HGH is produced in the anterior pituitary gland

20
Q

Anabolic Agents: Human Growth Hormone (HGH) Mechanism

A
  • HGH binds to cell receptors and secondary messengers to causes changes within the cell.
  • Promotes glucose and amino acid transport into muscle.
  • Protein anabolism
  • Stimulates lipolysis. (Fat breakdown)
  • Causes liver to release insulin-like growth factor (IGF)
    ~ Promotes anabolism in various tissues
    including muscle mass
21
Q

Anabolic Agents: Human Growth Hormone (HGH) Adverse Effects

A
  • Excess bone growth
  • Giantism (more likely to develop type 2 diabetes)
  • Insulin resistance
22
Q

Anabolic Agents: Beta Agonists

A
  • Remember that beta receptors are found throughout the body.
  • Typically used for respiratory diseases as stimulation of Beta-2 receptors in the respiratory tract cause bronchodilation.
  • NCAA and Olympic athletes allowed to use some beta-agonists with prior approval.
23
Q

Anabolic Agents: Beta Agonists Mechanism - Beta 1 Stimulation

A
  • Increased HR
  • Increased heart contractility
  • Increased renin - Increased BP
24
Q

Anabolic Agents: Beta Agonists Mechanism - Beta 2 Stimulation

A
  • Bronchodilation
  • Vasodilation in muscle
  • Lipolysis
  • Promotes glycogen formation
  • Promotes gluconeogenesis
  • Protein anabolism
25
Q

Anabolic Agents: Beta Agonists Adverse Effects

A
  • Muscle Tremor
  • Nervousness
  • Heart palpitations/Arrythmia
26
Q

Diuretics

A
  • Traditionally used to promote urine production in persons with HTN or edema associated with heart failure.
  • Caffeine and theophylline also have diuretic properties.
27
Q

Diuretics Mechanism

A
  • Act on the structures of the kidneys so that more sodium is excreted
    ~ Water follows the sodium so urine
    volume is increased as sodium is
    passed.
  • Used for weight loss.
  • Used to avoid positive urine drug test.
28
Q

Diuretics Adverse Effects

A
  • Hypokalemia - low potassium
  • Hyponatremia - low sodium
  • Dehydration
  • Heat Illness
29
Q

Beta Blockers

A
  • Typically used for CVD.
    ~ HTN
    ~ Stable Angina
    ~ Heart Failure
30
Q

Beta Blockers Mechanism

A
  • Remember that beta - blockers are beta receptor antagonists.
    ~ Block activation of the beta receptors.
    ~ Normal reactions to norepinephrine
    and epinephrine are blocked.
  • Primary benefits are in blocking Beta-1 receptors
    ~ Decrease Heart Rate
    ~ Decrease Heart Contractility
    ~ Decreased BP
  • Used to manage symptoms associated with anxiety (generalized anxiety)
  • Used to manage cardiovascular reaction to exercise
31
Q

Beta Blockers Adverse Effects

A
  • Hypotension
  • Bronchospasm
  • Decreased Cardiac Output
32
Q

Oxygen Delivery Enhancers: Oxygen Delivery

A
  • Oxygen Delivery
    ~ Oxygen travels on erythrocytes/RBCs.
    > RBCs contain hemoglobin
    molecules which bind to oxygen
    forming oxynemoglobin.
    > In tissues with low oxygen levels,
    hemoglobin releases its oxygen
    ~ Changes in level of hemoglobin or
    saturation of hemoglobin w/ O2 can
    increase O2 delivery
33
Q

Oxygen Delivery Enhancers: Blood Transfusion

A
  • Blood is removed, RBCs are separated and stored.
  • 2-3 months pass to allow the body to produce new RBCs to replace what was lost.
  • 3-5 days before competition stored RBCs infused.
    ~ Increases RBC/hemoglobin levels
34
Q

Oxygen Delivery Enhancers: Blood Transfusion Adverse Effects

A
  • Myocardial Infarction
  • Pulmonary/Cerebral Embolism
  • Infection - If another’s persons blood is used
  • Higher likelihood of clotting
35
Q

Oxygen Delivery Enhancers: Erythropoietin (EPO)

A
  • EPO is naturally occurring
    ~ Secreted from the kidneys and liver.
    ~ Released in reaction to low oxygen
    levels in the blood.
    > Stimulates the bone marrow to
    produce more RBC
  • In 1985 laporatory production began.
    ~ Used to treat those with anemia.
36
Q

Oxygen Delivery Enhancers: Erythropoietin (EPO) Adverse Effects

A
  • Myocardial Infarction
  • Pulmonary/Cerebral Embolism
  • Higher likelihood of clotting
37
Q

Oxygen Delivery Enhancers: Synthetic Oxygen Carriers

A
  • Proteins/chemicals with the ability to carry O2
    ~ Typically used as short term treatment
    for those in need of blood when blood
    is not available.
38
Q

Oxygen Delivery Enhancers: Synthetic Oxygen Carriers Adverse Effects

A
  • Myocardial Infarction
  • Pulmonary/Cerebral Embolism
  • Higher likelihood of clotting

Pathophysiology & Pharmacology (20 decks)

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