Paul (Drugs in sport)

Question 1

Doping

Answer 1

Earliest recorded examples in 1903- cocaine, strychnine, champagne
Elevating levels of things naturally found in the body e.g. Erythropoietin (EPO) and anabolic steroids
EPO increases VO2 max by 30%

Question 2

Consequences

Answer 2

Anabolic steroids- diverse side effects- timers, depression, sex changes

EPO- Belgian and Dutch cyclists diet from nocturnal heart attacks

Question 3

History of anti-doping

Answer 3

In 1967 the IOC published a list of banned substance classes and methods.
Things added to this list as time went on
- anabolic steroids
- caffeine restricted plus testosterone ratio
- probenecid and diuretics and blood transfusions
- hormones
- EPO
In 2004 the first WADA list came out which was evidence based

Question 4

Anabolic steroids

Answer 4

Androgens- masculinisation/protein
Controlled drugs, but readily supplied
Most common finding by testing
Performance enhancers
Myotrophic vs androgenic ratio
Motivates training by behavioural changes
“Designer steroids”
May be marketed as nutritional supplements

Question 5

Adverse effects of anabolic steroids

Answer 5

• Breast atrophy (shrinking) in women
• Gynaecomastia (enlargement of breasts) and enlarged nipples in men
• Cardiovascular
  
  • Increase in thrombotic events
  • MI or stroke
  • Raised LDL/Reduced HDL
  • Lowered plasma fibrinogen
  • Cardiacs damage and hypertrophy
• CNS
  
  • Increase libido
  • Hypomania, aggression, self-harm
• Hirsutism/male pattern baldness
• Liver function
• Acne
• deepening of voice
• Clitoral hypertrophy/testicular atrophy

Question 6

EPO (aerobic)

Answer 6

Early methods to increase availability
- altitude training (to increase RBC)
- transfusion of packed RBC

Erythropoietin primary regulator of RBC formation (synthesised in kidney)
- direct relationship between Hb levels and performance

EPO gene has allowed rHuEPO (used to treat anaemia)

Attractive to running/cycline

Question 7

GH (growth hormone), IGF-I (insulin growth factor) and insulin

Answer 7

• Anecdotal evidence of use
• Little evidence of improved performance
• Detection is challenging
  
  • Biomarkers of GH
  • IGF-I and Insulin abuse challenging

Question 8

Beta adrenergic system

Answer 8

Beta 2 is main target receptor.

Agonists
- Bronchodilation
- Anabolic actions
- Increased blood flow to muscles
- Enhance anti-inflammatory actions of corticosteroids (mast cell stabilisation)

Question 9

Beta blockers/ISA (intrinsic sympathomimetic activity)

Answer 9

Decrease heart rate and hand tremor
- No benefit to insurance sport
- Benefit in shooting, archery, gymnastics, etc

Indirectly acting sympathomimetics
Uptake 1 inhibitors
- Some banned, some allowed within specific plasma levels

Question 10

Stimulants

Answer 10

• Increase alertness
• Reduce fatigue
• Activate the CVS
• 62 drugs listed
• Mainly monoamines
  
  • ‘Inadvertant’ use in OTC medicines
  • Deliberate consumption
    
    • Recreational use
    • Performance enhancement

Question 11

Gene dopine

Answer 11

• There is currently much interest in the theoretical prospect rather than the current application of gene doping
• Genetic modification
• May be undetectable