1. Ergogenic Drug Use Jon Fravel, MS, ATC

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

3. 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 Th ươ ng –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 Socialist ă 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 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)

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

18. Substances S3. β 2 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.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). 2007. Available at: www.wada-ama.orgwww.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.