Lecture 17 - Performance Enhancing Drugs

Question 1

What were the earliest examples of doping in sports

Answer 1

strychnine, cocaine, caffeine

Question 2

What are performance enhancing drugs

Answer 2

substances used by individuals to improve their performance at a specific task

Question 3

What is WADA

Answer 3

World Anti-Doping Agency

Question 4

What are popular PEDs

Answer 4

anavar, trenbolone, testosterone, insulin, amphetamines, modafinil, ephedrine, cenbutarol

Question 5

What are adverse effects of steroids

Answer 5

high blood pressure
elevated LDL
liver damage and cancer
premature epiphyseal fusion
cardiomegaly

Question 6

What are adverse effects of amphetamines

Answer 6

hyperthermia, high blood pressure, sudden cardiac arrest

Question 7

What are adverse effects of growth hormone abuse

Answer 7

accelerate the development of pre-existing breast, prostate and colorectal cancer

Question 8

What are the adverse effects of T4/T3 abuse

Answer 8

hypoglycemia

Question 9

What are the adverse effects of Epo

Answer 9

hyperviscosity, extremety ishemia and cardiac events

Question 10

Why are endogenous substances challenging

Answer 10

1. Must differentiate between exogenous and endogenous sources
2. Must demonstrate that the concentration found cannot be the result of a
   normal physiological process or pathology
3. Under normal circumstances the reference interval can provide this answer,
   but additional evidence is required to account for the upper 2.5% (these are
   elite athletes)

Question 11

testosterone and doping

Answer 11

• Application: Used for its androgenic effects on building
  muscle mass and enhancing recovery after exercise
• Detection: Immunoassay or GC/LC-MSMS
• Formulations: Typically conjugated with an alkyl chain to
  prolong absorption
• Complications: Endogenous substance - Inspect the ratio of testosterone
  to epitestosterone

Question 12

What is the cutoff testosterone:epitesosterone for doping

Answer 12

6:1

Question 13

How to detect EPO

Answer 13

1. Identify excreted rhEPO fragments via laminar flow immunoassay
   (immunoaffinity chromatography) and confirm using isoelectric focusing
   (can be performed on site, detects differences in glycosylation)
2. Develop an athlete specific biological passport
   * This is WADA fancy pants terminology for establishing an athlete’s
   specific intra-individual variation

Question 14

What is isoelectric focusing

Answer 14

uses electrophoresis across a pH gradient to create a banding pattern (fingerprint) for each type of
EPO. The bands are the charge stable position of a specific glycosylation species for each EPO.

Question 15

how is human growth hormone detected

Answer 15

immunoassay and HPLC-MS/MS

Question 16

Is there an absolute ban on stimulants

Answer 16

Used to be an absolute ban on all stimulants including mild stimulants but now ephedrine*,
pseudoephedrine**, phenylpropanolamine and some other mild stimulants now allowed (but in
monitoring program)

Question 17

What are examples of diuretics

Answer 17

furosemide
thiazide diuretics

Question 18

What are some upcoming technologies

Answer 18

gene doping, secratagogues