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

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

Recent Cases Đỗ Thị Ngân Th ươ ng –Vietnamese Gymnast – Olympic Games – Furosemide IOC

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

Recent Cases NFL – Minnesota Vikings/New Orleans Saints – Banned Diuretic Star Cap – Bumetanide

Bumetanide (Bumex) Loop Diuretic – Heart failure Reason for Abuse – Weight loss – Masking agent

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

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

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

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

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

Level The Playing Field Republica Socialist ă România – Swimming

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

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

WADA Anti-Doping Code 2008 “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)

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

Substances S3. β 2 Agonists – Salbutamol, salmeterol, formoterol, clenbuterol, etc.

Substances S4. Hormone antagonists and modulators – Antiestrogens – Myostatin inhibitors

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

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

Methods M2. Chemical and Physical Manipulation – Physical tampering – IV infusions

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)

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

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

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."

References "Press Release - Hardy - August 2008", USADA ( ). Retrieved on 2 August 2008.Press Release - Hardy - August 2008USADA 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) Available at: NCAA Banned-Drug Classes NCAA. Indianapolis, Indiana Spitzer G. Doping with children. In: Peters C, Schulz T, Michna H, editors. Biochemical side effects of doping. Ko¨ ln (Germany): Sport ch Strauss; p. 127–39. Segura J. Sports. In: Karch SB, editor. Drug abuse handbook. Boca Raton (USA): CRC Press; p. 641–726.