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									Performance Enhancing
        Drugs

  Kim Edward Light, Ph.D.
  Professor, College of Pharmacy
  University of Arkansas for Medical Sciences
Objectives

    Define and identify the different classes of
     performance enhancing drugs.
    Discuss each class:
        Scope of use
        Actions and consequences
        Impact on users health
Performance Enhancing Drugs

    “Doping”
    United States Anti-Doping Agency
    Athletic competition
    Aesthetic or cosmetic
     appearance
Performance Enhancing Drugs
                          Build Mass & Strength
                            Anabolic Steroids
                          Human Growth Hormone
          Stimulants             Insulin
           Caffeine          Beta2-agonists                Calm Nerves
         Amphetamines             Other                      Beta-blockers
           Cocaine                                               THC
                                                               Alcohol
 Mask Drug
 Use
     Diuretics
  Epitestosterone
                                                           Analgesia
 Plasma expanders
                                                            Narcotics
     Secretion
                                                               ACTH
     inhibitors
          Reduce Weight                                     Cortisone
              diuretics     Enhance O2                   Local Anesthetics
                            Delivery
                                  Erythropoietin
                                   Blood doping
                            Artificial oxygen carriers
Performance Enhancing Drugs

    Building Mass and Strength
         Anabolic steroids
         Beta2 agonists
             Clenbuterol, Tertbutaline, Salbutamol, Fenoterol
         Human chorionic gonadotropin (hCG)
         Luteinizing Hormone (LH)
Performance Enhancing Drugs

    Building Mass and Strength
         Human growth hormone (hGH)
         Insulin-like growth factor (IGF-1)
         Insulin
Steroids
Anabolic Steroids

   Synthetic analogs of testosterone
   Anabolic effect = promote muscle growth and
    increase strength
   Androgenic effect = promote male sexual
    characteristics
   Treat delayed puberty and body wasting
    secondary to some diseases
   Anabolic steroid – DEA definition
Anabolic Steroids

   Anabolic/Androgenic Steroids (AAS)
   Common Use
       Orally
       Intramuscular
       Topical
   Patterns
       "Stacked"
       “Pyramid"
Anabolic Steroids
   Generic Name   Trade Name    TI

   Testosterone   Androderm     1
   Nandrolone      Deca-       11-12
   Decanoate      Durabolin
   Stanozolol     Winstrol     5-20
   Methenolone    Primobolan   7-16
Anabolic Steroids
    Side Effects
        Hypertension, acne, fluid retention
        Hypogonadism, gynecomastia
        Sleep disturbances
        Aggression, nose bleeds, depression
        Prostate enlargement, heart enlargement
        Appetite stimulation, libido reduction
        Balding, masculinization
        Liver problems including cancer
Anabolic Steroids

   Adverse Consequences
       Euphoria, well-being,
       Mood swings
       “Roid Rage”
       Increased frequency of injuries
   Other drug use
       Opiates
Anabolic Steroids

    Body Dysmorphia
        The Adonis Complex
            Megorexia,
            Bigorexia,
            muscle dysmorphia
Anabolic Promoters


   Androstenediol
   Androstenedione
   DHEA – dehydroepiandrostenedione
   Tetrahydrogestrinone (THG)
Creatine

   Amino acid available from diet
   Converted to phosphocreatine
   Source of phosphate-bond energy
   Resynthesis of ATP during exercise
   Retention of water
   Enhanced muscle overuse and injury
Performance Enhancing Drugs
                              Build Mass & Strength
                                Anabolic Steroids
                              Human Growth Hormone
             Stimulants              Insulin
              Caffeine           Beta2-agonists                  Calm Nerves
            Amphetamines              Other                       Beta-blockers
              Cocaine                                                 THC
                                                                    Alcohol
Mask Drug Use
     Diuretics
  Epitestosterone
 Plasma expanders
 Secretion inhibitors                                           Analgesia
                                                                 Narcotics
                                                                    ACTH
             Reduce Weight                                       Cortisone
                  diuretics     Enhance O2 Delivery           Local Anesthetics
                                       Erythropoietin
                                        Blood doping
                                 Artificial oxygen carriers
Enhancing O2 Delivery


    Erythropoietin (EPO)
    Artificial oxygen carriers
        Perfluorocarbons
        Synthetic or modified hemoglobin
        Liposome-encased hemoglobin
    Blood doping
Performance Enhancing Drugs
                              Build Mass &
                                Strength
                             Anabolic Steroids
           Stimulants      Human Growth Hormone
            Caffeine              Insulin                   Calm Nerves
          Amphetamines        Beta2-agonists                  Beta-blockers
            Cocaine                Other                          THC
                                                                Alcohol
  Mask Drug
  Use
      Diuretics
   Epitestosterone
  Plasma expanders
                                                            Analgesia
                                                             Narcotics
      Secretion
                                                                ACTH
      inhibitors
           Reduce Weight                                     Cortisone
               diuretics    Enhance O2                    Local Anesthetics
                            Delivery
                                   Erythropoietin
                                    Blood doping
                             Artificial oxygen carriers
Masking Drug Use

   Epitestosterone
       Testosterone / epitestosterone < 6 normally
   Plasma Expanders
       Starch or protein based physiological salt
        solutions
   Secretion Inhibitors
       Probenecid
Performance Enhancing Drugs
                           Build Mass & Strength
                             Anabolic Steroids
                           Human Growth Hormone
           Stimulants             Insulin
            Caffeine          Beta2-agonists
                                                            Calm Nerves
          Amphetamines             Other
                                                              Beta-blockers
            Cocaine                                               THC
                                                                Alcohol
  Mask Drug
  Use
      Diuretics
   Epitestosterone
  Plasma expanders                                          Analgesia
      Secretion                                              Narcotics
      inhibitors                                                ACTH
           Reduce Weight                                     Cortisone
               diuretics                                  Local Anesthetics
                             Enhance O2
                             Delivery
                                   Erythropoietin
                                    Blood doping
                             Artificial oxygen carriers
Performance Enhancing Drugs
  Monitoring The Future – Annual Study of Drug Use




 For the 2004 survey, 49,474 students in a nationally representative
 sample of 406 public and private schools were surveyed about
 lifetime, annual, and 30-day use. Bracketed figures in the tables
 below indicate a significant change between 2003 and 2004.
Performance Enhancing Drugs

   The United States Anti-Doping Agency (USADA)
    http://www.usantidoping.org/
   In 2002 a total of 5,659 tests were conducted and
    in 2003 the total was 6,880 tests.
   Approximately 2,500 athletes
   Positive rates were ~ 0.7-1.0% of tests
Summary
   Definition and scope of Performance
    Enhancing Drugs
   Identified the types of approaches and agents
    employed
   Focus on Anabolic Steroids
   Prevalence of use in our society
   Resources for further information
       http://www.steroidabuse.gov/
       http://www.usantidoping.org/

								
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