Non conventional using drugs By: Dr Vahedi

Lifestyle drugs An eclectic group of drugs that are used for non- medical purposes Including : A) Drugs of abuse B) Cosmetic purposes or for purely social reasons C) Enhance athletic or other performance

Lifestyle drugs & medicines, excluding drugs in sport “lifestyle use” Primary clinical use ExampleCategory Erectile enhancment Erectile dysfunction sildenafilMedicines approved for specific indication but that can also be used for other lifestyle purposes Regrowth of hair HTNminoxidilMedicines approved for specefic indications that can also be used to satisfy “lifestyle choices” or to treat “lifestyle disease” Cosmetic alteration Relief of muscle spasm Botulinum toxin Drugs have slight or no current clinical use but which fall into the lifestyle category Recreational usage Non as suchMDMA, Ecstasy Drugs that have no clinical utility but which are used to satisfy lifestyle requirements Widespread for many conditions nonHerbal preparation Natural products,largely unregulated with claim effects but which cater to lifestyle needs or desires

Enhance athletic or other enhance performance drugs 1) Anabolic Agents 2) Hormones and related substances 3) β2 –Adrenoceptor agonists 4) β- Adrenoceptor antagonists 5) Stimulants 6) Diuretics 7) Narcotic analgesics

Drugs in sport Anabolic agents  Androgenic steroids ( Testosteron, Nandrolone,…)  Effects : Increase Muscle development Muscle mass & improve sporting performance↑ Muscle strength ? Increase aggression and competitivness serious long term side effects

Drugs in sport Other Anabolic Agents :  Clenbuterol: ( Anabolic androgenic + agonist action on β2 adrenoceptors)  selective androgen receptor modulators (SARMs) : aryl propionamid analogs Bicyclic hydantoein analogs  tibolone ( estrogen activity +weak androgenic activity)

Drugs in sport Hormones and related substances  EPO : Increased erythrocyte formation & increased oxygen transport & blood viscosity Side effects: CAD, Strokes (trombos formation), HTN  Human growth hormone: Effects: ↑lean body mass, ↓fat, accelerate recovery, cardiac hypertrophy,acromegaly, liver damage, ↑cancer risk

Drugs in sport Hormones and related substances Insulin:  To promote glucose uptake and enegy production in muscle  Probably ineffective in improving performance  Side effect: hypoglycemia

Drugs in sport Hormones and related substances Other related substances:  Chorionic Gonadotrophin (CG) and Luteinizing Hormone (LH) in male  Corticotrophins  Insulin-like Growth Factor-1 (IGF-1)

Drugs in sport β2 –Adrenoceptor agonists (Exp: Salbutamol formoterol, salmeterol ) Used by Runners, swimmers. Mechanism: ↑O2 uptake and transport (Bronchodilation) cardiac function, Controlled studies show no improvement performance β- Adrenoceptor antagonists (Exp: propranolol)  used to reduce tremor and anexity in precision sports (Shooters, ski jumpers, archery)  Negative effect on endurance  Depression, bronchospasm, fatigue

Drugs in sport Stimulants: Ephedrine, methylephenidate, fenfluramine, cocaein, amiphenazole, strychnine,taurine  Effects: Some trials have shawn ; to improve performance in spriting, weightlifting. Increase muscle strengh and reduce muscle fatigue Surprisingly Caffeine apears to be more effective in improving muscle performance than other more powerful stimulants. Several deaths with taking amphetamines &ephedrine – like drugs

Drugs in sport Stimulants: – Amphetamines  Delay fatigue, increase alertness, enhance speed, power, endurance, concentration  Side effects: Hypertension, angina, vomiting, abdominal pain, cerebral hemorrhage, dependence, death

Drugs in sport Stimulants: – Caffeine  Shortened reaction time, improved concentration, diuresis  Primary theory is enhanced release of FFA, sparing glycogen. Stimulate the release of Ca 2+ in muscle cells  Glycogen sparing leading to delayed fatigue  > 12 ug/mL is a positive urine per IOC  Side effects: Dyspepsia, cardiac damage, combination with other stimulants (e.g. ephedrine) may be fatal

Drugs in sport  Diuretics:  Rapid weight loss  also to mask presence of other agent in urine by dilution – Overall negative impact on performance – Dehydration, hypotension, muscle cramps, electrolyte imbalance  Narcotic, analgesics:  used to mask injury- associated pain  Increased risk of further injury, dependence, drowsiness, mental clouding; in high doses: respiratory depression, hypotension

CONCLUSION

Mechanism enhance performance drugs PHYSIOLOGICAL REASONS Lose weight, train harder Mask injury and reduce tiredness To build muscle, increase energy Increase oxygen transport

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