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Ergogenic Drug Use

Ergogenic Drug Use. Jon Fravel, MS, ATC. Recent Cases. Jessica Hardy- Swimmer 1 US Olympic Trials July 1 (Negative) Following 100 Breast July 4 (Positive) July 6 (Negative) Clenbuterol. Clenbuterol. Bronchodilator/Anabolic Agent Longlasting

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Ergogenic Drug Use

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  1. Ergogenic Drug Use Jon Fravel, MS, ATC

  2. Recent Cases • Jessica Hardy- Swimmer1 • US Olympic Trials • July 1 (Negative) Following 100 Breast • July 4 (Positive) • July 6 (Negative) • Clenbuterol

  3. Clenbuterol • Bronchodilator/Anabolic Agent • Longlasting • Domestic Rx equine use for airway obstruction • Abroad on humans • Bronchodilation/Asthmatics • Reasons for abuse • Anabolic effect • Weightloss • Bodybuilders • Weightloss Supplement of the Stars! • Lindsay Lohan

  4. Recent Cases • Đỗ Thị Ngân Thương –Vietnamese Gymnast • Olympic Games • Furosemide • IOC

  5. Furosemide • Loop Diuretic (Lasix) • Congestive Heart failure • Edema • WADA Banned Substance • Masking agent • Reasons for Abuse • Masking agent • Weight loss

  6. Recent Cases • NFL • Minnesota Vikings/New Orleans Saints • Banned Diuretic • Star Cap • Bumetanide

  7. Bumetanide (Bumex) • Loop Diuretic • Heart failure • Reason for Abuse • Weight loss • Masking agent

  8. History • Long history of performance-enhancing drugs (PED) • Greek/Ancient Olympics • Roman Gladiators • IOC in the 1960’s • World Anti-Doping Agency (1999)

  9. History of PED’s • 1. Modern Olympic Games-1970’s • Administration immediately prior/during competition • Stimulants • Narcotics • Drugs of Abuse

  10. History of PED’s • 2. Repeated administration over a period of time. • Anabolic Steroids

  11. History of PED’s • 3. Pharmaceutical development/involvement of protein chemistry, moelcular biology, and genetic engineering. • Peptide Hormones • EPO • Growth Hormone • Gonadotropins

  12. History of PED’s • 4? Gene doping via gene therapy.

  13. Level The Playing Field • Republica Socialistă România • Swimming

  14. Clinical Trials • Phase I Clinical trials • Activity • Dosage range • Side Effects • Phase II Clinical Trials • Efficacy • Evaluate Safety • Phase III • Confirm Evidence • Monitor Side Effects

  15. Side Effects • Off-Label Drugs • Except Designer Steroids • Overdosing • Acute/Chronic • Drug/Drug Interaction • Parallel administration for combined therapeutic schemes

  16. WADA Anti-Doping Code2008 “Prohibited List” • S1. Anabolic Agents • 1. Anabolic androgenic steroids • a. Exogenous Anabolic androgenic steroids • b. Endogenous anabolic androgenic steroids • 2. Other anabolic agents • Clenbuterol and selective androgen receptor modulators)

  17. Substances • S2. Hormones and related substances • EPO • HGH • Insulin-like growth factors • Gonadotropins • Insulin

  18. Substances • S3. β2 Agonists • Salbutamol, salmeterol, formoterol, clenbuterol, etc.

  19. Substances • S4. Hormone antagonists and modulators • Antiestrogens • Myostatin inhibitors

  20. Substances • S5. Diuretics and other masking agents • Diuretics • Epitestosterone • Probenecid • α-reductase inhibitors • Plasma expanders

  21. Prohibited Methods • M1. Enhancement of oxygen transfers • Blood transfusions • Blood derivatives/analogs

  22. Methods • M2. Chemical and Physical Manipulation • Physical tampering • IV infusions

  23. Methods • M3. Gene Doping • “Non-therapeutic use of cells, genes, genetic elements, or modulation of gene expression, having the capacity to improve athletic performance” (WADA)

  24. Substances and Methods Prohibited in Competition • S6. Stimulants • Amphetamine, cocaine, etc • S7. Narcotics • Morphine, opioids • S8. Cannabinoids • Hashish, marijuana • S9. Gluccocorticosteroids

  25. Substances Prohibited in Particular Sports • P1. Alcohol • P2. β-Blockers

  26. Olympic Motto • "Citius, Altius, Fortius” • Faster, Higher, Stronger • Olympic Creed • "The most important thing in the Olympic Games is not to win but to take part, just as the most important thing in life is not the triumph but the struggle. The essential thing is not to have conquered but to have fought well."

  27. References • "Press Release - Hardy - August 2008", USADA (2008-08-01). Retrieved on 2 August 2008. • Botre, F. Pavan, A. Enhancement Drugs and the Athlete. Neurol Clin 26 (2008) 149–167 • Wagner JC. Enhancement of athletic performance with drugs. An overview. Sports Med • 1991;12:250–65. • Use of Performance-Enhancing Substances Ped 9/9/05 • The World Anti-Doping Code. World anti-doping agency. Montreal (Canada). 2007. Available at: www.wada-ama.org • NCAA Banned-Drug Classes 2007-08. NCAA. Indianapolis, Indiana. 2008. • Spitzer G. Doping with children. In: Peters C, Schulz T, Michna H, editors. Biochemical side effects of doping. Ko¨ ln (Germany): Sport ch Strauss; 2001. p. 127–39. • Segura J. Sports. In: Karch SB, editor. Drug abuse handbook. Boca Raton (USA): CRC Press; 1998. p. 641–726.

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