Sports and Substance Abuse Flashcards
Why are diuretics abused in sports?
- excretion enhancement to lose weight rapidly prior to competition where weight limits are set
- aid in excretion prior to testing or dilute the presence of illegal substances in urine
Do diuretics abuse have a positive or negative effect on performance in sports?
Negative.
What are the adverse effects of diuretic abuse in sports?
Dehydration, hypotension, muscle cramps, electrolyte imbalances.
Why are opioids abused in sports?
Narcotics permit athletes to compete w/ musculoskeletal injuries.
What are the adverse effects of opioid abuse in sports?
Increased risk of further injury, possible dependence, drowsiness, mental clouding; in high doses: respiratory depression and hypotension.
Why are beta blockers abused in sports?
Used for their anxiolytic and anti tremor effects.
Do beta blockers have a positive or negative effect on performance in sports?
May be negative effects on anaerobic and aerobic endurance.
What are the adverse effects of beta blocker abuse in sports?
Depression, bronchospasm, worsening vascular problems, fatigue.
Why are glucocorticoids abused in sports?
Given their psychostimulant effects and anti-inflammatory properties, used to fight fatigue and relieve pain.
Define androgen.
Any hormone with testosterone like actions.
Define anabolism.
Cellular synthesis of organic molecules, including proteins (builds muscle).
Define ergogenic acid.
Any substance that aids performance.
What is testosterone?
A steroid hormone produced by tissues, mainly a product of endocrine glands (testes, ovaries, adrenal glands).
How are anabolic steroids administered?
Orally, IM, IV, SC, or with creams and patches.
How are alkylated androgens different from testosterone?
- addition of a methyl or ethyl group to the 17-carbon position
- inhibits the hepatic degradation of the molecule, extending the half life and making it active when administered orally
What is the adverse effect of alkylated androgens?
Dose related hepatotoxicity.
What are examples of alkylated testosterones/androgens?
Methyltestosterone, oxandrolone, fluoxymesterone.
What are examples of testosterone esters?
Enanthate, cypionate, propionate.
How are testosterone esters different from testosterone?
- esterification to the 17-beta hydroxy group makes it more lipophilic
- prolongs the presence of testosterone in the blood
What is the link between testosterone esters’ ester chains and half life?
- the shorter the ester chain, the shorter the half life, the quicker the drug enters the circulation
- the longer the ester chain, the longer the half life, the slower it is released into the circulation
What are the effects of anabolic steroid use on performance? (3)
- anabolic effect (protein synthesis in skeletal muscle cells)
- anti-catabolic effect (reverse catabolic effects, increase muscle size and strength)
- enhancement of aggressive behaviour (greater training load and advantageous during competition)
What are the uses of anabolic steroids in clinical medicine?
- catabolic or tissue depleting processes treatment (chronic infections, extensive surgery, severe trauma, HIV infection)
- hypogonadism treatment
- growth failure/pituitary dwarfism
- anemia treatment (stimulates bone marrow)
- promotion of weight gain in undernourish debilitated patients
What can be used to counteract gynecomastia from AAS use?
An aromatase inhibitor or estrogen receptor antagonist.
Why might an athlete take human chorionic gonadotropin (hCG)?
To counteract the decrease in testicular size, and to counteract hypogonadism and oligospermia.
Describe the ‘cycling’ steroid protocol.
- involves taking multiple doses of steroids over a specific period of time, stopping for a period, and starting again
- steroid cycle is the period in time where an individual is actively taking anabolic steroids
- cycle lasts 7 - 14 weeks
Describe the ‘stacking’ steroid protocol.
- abusers ‘stack’ drugs, meaning the take two or more different anabolic steroids
- this is b/c, due to depression of endogenous steroidogenesis, the body requires diff steroids to mimic the normal hormonal imbalance
- diff steroids are used during diff phases of the cycle to avoid development of tolerance
Describe the ‘pyramiding’ steroid protocol.
- users slowly escalate steroid use (increasing the number of steroids or the dose and frequency of one or more steroids used at one time), reaching a peak amount at mid-cycle and gradually tapering the dose toward the end of the cycle
- cycles of 6 - 12 weeks
Describe the ‘bridging’ steroid protocol.
Refers to halting the use of fat soluble, long acting (oral) alkylated agents in time for them to clear the urine, and using water soluble, shorter acting injectable agents.
What are two ways anabolic steroids can be detected?
- Higher urinary ratio of testosterone to epitestosterone (4:1), which rarely occurs naturally.
- Lower urinary ratio of 13C to 12C in AAS users.
What is the role of probenecid in drug abuse in sports?
Inhibits the excretion of AAS metabolites into the urine, so keeps metabolites in body longer.
What are the benefits of human growth hormone (HGH) in sports?
- improves muscle and cardiac function
- normalizes serum lipid concentrations
- increases RBC mass and O2 carrying capacity
- decreases subcutaneous fat
- stimulates lipolysis
- improves mood and sense of well being
What is the use of hGH in clinical medicine?
- maintaining muscle mass in wasting due to AIDS
- children w/ growth hormone deficiency
What are the adverse effects of hGH?
- effects of long term use not reversible
- gigantism, acromegaly, glucose intolerance, impotence, myalgia, cardiac effects (ischemic heart disease, congestive cardiac failure, cardiomyopathy)
How can hGH use be detected?
- isoform test that shows a higher ratio of growth hormone that can be produced both by the body and synthetically
- detects hGH use within weeks
What are the benefits of erythropoietin (EPO) use in sports?
- increase oxygen carrying capacity
- increases maximum oxygen uptake by tissue which enhances athletic performance
What is the use of EPO in clinical medicine?
- anemia
- chronic renal failure
- blood transfusion
- surgery w/ excessive blood loss
What are the adverse effects of EPO?
- increased viscosity
- increased risk of thromboembolic events (stroke, MI, PE)
- increased systolic BP during sub maximal exercise
How can EPO use be detected?
- indirect and direct methods
- accurate urine test that detects diff b/w normal and synthetic EPO
What is creatine?
An nitrogenous compound synthesized in the body by the deliver, pancreas and kidney, and can be absorbed through the diet from fish and meat.
What are the adverse effects of creatine?
- muscle cramping
- diarrhea
- dizziness
- dehydration
- significant weight gain secondary to water retention
