Sports and Substance Abuse

Question 1

Why are diuretics abused in sports?

Answer 1

• 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

Question 2

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

Answer 2

Negative.

Question 3

What are the adverse effects of diuretic abuse in sports?

Answer 3

Dehydration, hypotension, muscle cramps, electrolyte imbalances.

Question 4

Why are opioids abused in sports?

Answer 4

Narcotics permit athletes to compete w/ musculoskeletal injuries.

Question 5

What are the adverse effects of opioid abuse in sports?

Answer 5

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

Question 6

Why are beta blockers abused in sports?

Answer 6

Used for their anxiolytic and anti tremor effects.

Question 7

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

Answer 7

May be negative effects on anaerobic and aerobic endurance.

Question 8

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

Answer 8

Depression, bronchospasm, worsening vascular problems, fatigue.

Question 9

Why are glucocorticoids abused in sports?

Answer 9

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

Question 10

Define androgen.

Answer 10

Any hormone with testosterone like actions.

Question 11

Define anabolism.

Answer 11

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

Question 12

Define ergogenic acid.

Answer 12

Any substance that aids performance.

Question 13

What is testosterone?

Answer 13

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

Question 14

How are anabolic steroids administered?

Answer 14

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

Question 15

How are alkylated androgens different from testosterone?

Answer 15

• 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

Question 16

What is the adverse effect of alkylated androgens?

Answer 16

Dose related hepatotoxicity.

Question 17

What are examples of alkylated testosterones/androgens?

Answer 17

Methyltestosterone, oxandrolone, fluoxymesterone.

Question 18

What are examples of testosterone esters?

Answer 18

Enanthate, cypionate, propionate.

Question 19

How are testosterone esters different from testosterone?

Answer 19

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

Question 20

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

Answer 20

• 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

Question 21

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

Answer 21

• 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)

Question 22

What are the uses of anabolic steroids in clinical medicine?

Answer 22

• 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

Question 23

What can be used to counteract gynecomastia from AAS use?

Answer 23

An aromatase inhibitor or estrogen receptor antagonist.

Question 24

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

Answer 24

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

Question 25

Describe the 'cycling' steroid protocol.

Answer 25

- 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

Question 26

Describe the 'stacking' steroid protocol.

Answer 26

- 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

Question 27

Describe the 'pyramiding' steroid protocol.

Answer 27

- 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

Question 28

Describe the 'bridging' steroid protocol.

Answer 28

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.

Question 29

What are two ways anabolic steroids can be detected?

Answer 29

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.

Question 30

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

Answer 30

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

Question 31

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

Answer 31

- 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

Question 32

What is the use of hGH in clinical medicine?

Answer 32

- maintaining muscle mass in wasting due to AIDS | - children w/ growth hormone deficiency

Question 33

What are the adverse effects of hGH?

Answer 33

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

Question 34

How can hGH use be detected?

Answer 34

- 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

Question 35

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

Answer 35

- increase oxygen carrying capacity | - increases maximum oxygen uptake by tissue which enhances athletic performance

Question 36

What is the use of EPO in clinical medicine?

Answer 36

- anemia - chronic renal failure - blood transfusion - surgery w/ excessive blood loss

Question 37

What are the adverse effects of EPO?

Answer 37

- increased viscosity - increased risk of thromboembolic events (stroke, MI, PE) - increased systolic BP during sub maximal exercise

Question 38

How can EPO use be detected?

Answer 38

- indirect and direct methods | - accurate urine test that detects diff b/w normal and synthetic EPO

Question 39

What is creatine?

Answer 39

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

Question 40

What are the adverse effects of creatine?

Answer 40

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