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Patient Care III > Sports and Substance Abuse > Flashcards

Sports and Substance Abuse Flashcards

1
Q

Why are diuretics abused in sports?

A
  • 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
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2
Q

Do diuretics abuse have a positive or negative effect on performance in sports?

A

Negative.

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3
Q

What are the adverse effects of diuretic abuse in sports?

A

Dehydration, hypotension, muscle cramps, electrolyte imbalances.

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4
Q

Why are opioids abused in sports?

A

Narcotics permit athletes to compete w/ musculoskeletal injuries.

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5
Q

What are the adverse effects of opioid abuse in sports?

A

Increased risk of further injury, possible dependence, drowsiness, mental clouding; in high doses: respiratory depression and hypotension.

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6
Q

Why are beta blockers abused in sports?

A

Used for their anxiolytic and anti tremor effects.

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7
Q

Do beta blockers have a positive or negative effect on performance in sports?

A

May be negative effects on anaerobic and aerobic endurance.

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8
Q

What are the adverse effects of beta blocker abuse in sports?

A

Depression, bronchospasm, worsening vascular problems, fatigue.

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9
Q

Why are glucocorticoids abused in sports?

A

Given their psychostimulant effects and anti-inflammatory properties, used to fight fatigue and relieve pain.

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10
Q

Define androgen.

A

Any hormone with testosterone like actions.

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11
Q

Define anabolism.

A

Cellular synthesis of organic molecules, including proteins (builds muscle).

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12
Q

Define ergogenic acid.

A

Any substance that aids performance.

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13
Q

What is testosterone?

A

A steroid hormone produced by tissues, mainly a product of endocrine glands (testes, ovaries, adrenal glands).

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14
Q

How are anabolic steroids administered?

A

Orally, IM, IV, SC, or with creams and patches.

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15
Q

How are alkylated androgens different from testosterone?

A
  • 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
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16
Q

What is the adverse effect of alkylated androgens?

A

Dose related hepatotoxicity.

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17
Q

What are examples of alkylated testosterones/androgens?

A

Methyltestosterone, oxandrolone, fluoxymesterone.

18
Q

What are examples of testosterone esters?

A

Enanthate, cypionate, propionate.

19
Q

How are testosterone esters different from testosterone?

A
  • esterification to the 17-beta hydroxy group makes it more lipophilic
  • prolongs the presence of testosterone in the blood
20
Q

What is the link between testosterone esters’ ester chains and half life?

A
  • 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
21
Q

What are the effects of anabolic steroid use on performance? (3)

A
  • 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)
22
Q

What are the uses of anabolic steroids in clinical medicine?

A
  • 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
23
Q

What can be used to counteract gynecomastia from AAS use?

A

An aromatase inhibitor or estrogen receptor antagonist.

24
Q

Why might an athlete take human chorionic gonadotropin (hCG)?

A

To counteract the decrease in testicular size, and to counteract hypogonadism and oligospermia.

25
Q

Describe the ‘cycling’ steroid protocol.

A
  • 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
26
Q

Describe the ‘stacking’ steroid protocol.

A
  • 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
27
Q

Describe the ‘pyramiding’ steroid protocol.

A
  • 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
28
Q

Describe the ‘bridging’ steroid protocol.

A

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.

29
Q

What are two ways anabolic steroids can be detected?

A
  1. Higher urinary ratio of testosterone to epitestosterone (4:1), which rarely occurs naturally.
  2. Lower urinary ratio of 13C to 12C in AAS users.
30
Q

What is the role of probenecid in drug abuse in sports?

A

Inhibits the excretion of AAS metabolites into the urine, so keeps metabolites in body longer.

31
Q

What are the benefits of human growth hormone (HGH) in sports?

A
  • 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
32
Q

What is the use of hGH in clinical medicine?

A
  • maintaining muscle mass in wasting due to AIDS

- children w/ growth hormone deficiency

33
Q

What are the adverse effects of hGH?

A
  • effects of long term use not reversible
  • gigantism, acromegaly, glucose intolerance, impotence, myalgia, cardiac effects (ischemic heart disease, congestive cardiac failure, cardiomyopathy)
34
Q

How can hGH use be detected?

A
  • 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
35
Q

What are the benefits of erythropoietin (EPO) use in sports?

A
  • increase oxygen carrying capacity

- increases maximum oxygen uptake by tissue which enhances athletic performance

36
Q

What is the use of EPO in clinical medicine?

A
  • anemia
  • chronic renal failure
  • blood transfusion
  • surgery w/ excessive blood loss
37
Q

What are the adverse effects of EPO?

A
  • increased viscosity
  • increased risk of thromboembolic events (stroke, MI, PE)
  • increased systolic BP during sub maximal exercise
38
Q

How can EPO use be detected?

A
  • indirect and direct methods

- accurate urine test that detects diff b/w normal and synthetic EPO

39
Q

What is creatine?

A

An nitrogenous compound synthesized in the body by the deliver, pancreas and kidney, and can be absorbed through the diet from fish and meat.

40
Q

What are the adverse effects of creatine?

A
  • muscle cramping
  • diarrhea
  • dizziness
  • dehydration
  • significant weight gain secondary to water retention

Patient Care III (6 decks)

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