Performance Enhancing Drugs Flashcards
International Olympic Committee Definition
- 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.
Stimulants: Amphetamines
- Originally used for the treatment of asthma.
~ Used now for ADHD and narcolepsy. - Controlled Substances
~ Illegal to use or posses without a
prescription
Stimulants: Amphetamines Mechanism - Binding
- 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
Stimulants: Amphetamines Mechanism - Increase Release of..
- 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.
Stimulants: Amphetamines Adverse Effects - Minor
- Decreased Appetite
- Fever
- Sweating
- Headache
- Restlessness
- Anxiety
Stimulants: Amphetamines Adverse Effects - Major
- Arrhythmia
~ Sudden Cardiac Death - Stroke
- Psychosis
- Predisposed to heat stroke.
- Dependence
Stimulants: Caffeine
- Banned by the NCAA, but only if levels are over a specific amount (15 micrograms/mL) = 6 cups of coffee before testing
Stimulants: Caffeine Mechanism
- 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
Stimulants: Caffeine Adverse Effects
- Anxiety
- Jitters
- Dizziness
- Headache
- Diuresis
~ Inhibits anti-diuretic hormone (ADH)
release = pt. pees more
Stimulants: Ephedrine
- 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.
Stimulants: Ephedrine Mechanism and Adverse Effects
Same as Amphetamines but less magnitude
Anabolic Agents
- 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
Anabolic-Androgenic Steroids (AAS): Oral Administration
- Shorter acting
- Drug is subject to first pass effect
~ Sometimes modified (alkalized) to
prevent breakdown in the liver
Anabolic-Androgenic Steroids (AAS): Parenteral Administration
- Longer acting
- Sometimes modified into esters
~ Prolongs half life
~ Less water soluble - less/slower entry
into circulatory system - Injected into muscle
Anabolic-Androgenic Steroids (AAS): Mechanism - Receptors
- AAS receptors found in most cells
~ AAS interact with cells DNA casing
stimulation of messenger RNA and
production of new protein
Anabolic-Androgenic Steroids (AAS): Effects
- 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
Muscle Mass Mechanism: Increased Protein Synthesis
- 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
AAS Adverse Effects
- Liver Disease
- Dyslipidemia: Low HDL and High LDL
- Hypogonadism
~ Small testes
Anabolic Agents: Human Growth Hormone (HGH)
HGH is produced in the anterior pituitary gland
Anabolic Agents: Human Growth Hormone (HGH) Mechanism
- 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
Anabolic Agents: Human Growth Hormone (HGH) Adverse Effects
- Excess bone growth
- Giantism (more likely to develop type 2 diabetes)
- Insulin resistance
Anabolic Agents: Beta Agonists
- 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.
Anabolic Agents: Beta Agonists Mechanism - Beta 1 Stimulation
- Increased HR
- Increased heart contractility
- Increased renin - Increased BP
Anabolic Agents: Beta Agonists Mechanism - Beta 2 Stimulation
- Bronchodilation
- Vasodilation in muscle
- Lipolysis
- Promotes glycogen formation
- Promotes gluconeogenesis
- Protein anabolism
Anabolic Agents: Beta Agonists Adverse Effects
- Muscle Tremor
- Nervousness
- Heart palpitations/Arrythmia
Diuretics
- Traditionally used to promote urine production in persons with HTN or edema associated with heart failure.
- Caffeine and theophylline also have diuretic properties.
Diuretics Mechanism
- 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.
Diuretics Adverse Effects
- Hypokalemia - low potassium
- Hyponatremia - low sodium
- Dehydration
- Heat Illness
Beta Blockers
- Typically used for CVD.
~ HTN
~ Stable Angina
~ Heart Failure
Beta Blockers Mechanism
- 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
Beta Blockers Adverse Effects
- Hypotension
- Bronchospasm
- Decreased Cardiac Output
Oxygen Delivery Enhancers: Oxygen Delivery
- 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
Oxygen Delivery Enhancers: Blood Transfusion
- 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
Oxygen Delivery Enhancers: Blood Transfusion Adverse Effects
- Myocardial Infarction
- Pulmonary/Cerebral Embolism
- Infection - If another’s persons blood is used
- Higher likelihood of clotting
Oxygen Delivery Enhancers: Erythropoietin (EPO)
- 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.
Oxygen Delivery Enhancers: Erythropoietin (EPO) Adverse Effects
- Myocardial Infarction
- Pulmonary/Cerebral Embolism
- Higher likelihood of clotting
Oxygen Delivery Enhancers: Synthetic Oxygen Carriers
- 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.
Oxygen Delivery Enhancers: Synthetic Oxygen Carriers Adverse Effects
- Myocardial Infarction
- Pulmonary/Cerebral Embolism
- Higher likelihood of clotting
