Drugs in Sport. Fifth Edition. Edited by David R. Mottram. Routledge. Taylor & Francis Group LONDON AND NEW YORK

Transcription

1 Drugs in Sport Fifth Edition Edited by David R. Mottram Routledge Taylor & Francis Group LONDON AND NEW YORK

2 Contents Contributors xv SECTION I The basis for and regulation of drug use in sport I 1 An introduction to drugs and their use in sport Definition ofa drug Classification and description ofdrug names Development of new drugs Dosage forms for drug delivery to the body The absorption, distribution, metabolism and elimination of drugs Effect of exercise on pharmacokinetics Drugs and their targets Agonists and antagonists Side effects of drugs Complex drug reactions Drugs and the law Why drugs are used in sport References 19 2 A historical perspective of doping and anti-doping in sport Introduction The ancient Olympic and Roman games Nineteenth Century Early twentieth Century 23

3 viii Contents 2.5 Nineteen forties and nineteen fifties Nineteen sixties Nineteen seventies Nineteen eighties Nineteen nineties Two thousand and beyond The race between doping and anti-doping References 33 3 Medicines for Olympic and Commonwealth Games 35 MARK STUART 3.1 Introduction The Games polyclinic Medical Services at sporting venues The Games formulary Patterns of drug use Prescribing procedures Drug information Services Summary References 45 SECTION 2 Substances and methods prohibited in sport 47 4 Anabolic agents ^ ALAN J. GEORGE AND 4.1 Introduction The testosterone family Structural analogues of testosterone: the anabolic steroids Anabolic steroids and sport Precursors, nandrolone and steroid metabolites Anabolic steroid side effects with particular reference to athletes Detection of testosterone and anabolic steroids Other anabolic agents References 76

4 Contents ix 5 Peptide hormones and related substances 82 ALANJ. GEORGE AND 5.1 Introduction Erythropoiesis-stimulating agents Human growth hormone (hgh) The abuse ofhgh in sport Human chorionic gonadotropin (hcg) Luteinizing hormone (LH) and its use in sport Insulin and its use in sport Corticotropins References 94 6 Beta-2 agonists 98 DAVID J. ARMSTRONG AND 6.1 Introduction Asthma and its treatment Exercise and asthma Management of asthma Management of exercise-induced asthma (EIA) Pharmacology ofß 2 -agonists ß 2 -agonists and the WADA prohibited list The use ofß 2 -agonists in sport References Hormone antagonists and modulators Introduction Hormone antagonists and modulators and the WADA prohibited list Clinical use of hormone antagonists and modulators The use of hormone antagonists and modulators in sport References Diuretics and other masking agents History of diuretics and other masking agents in sport Action and use of diuretics in sport Action and uses of other masking agents in sport 126

5 x Contents 8.4 Current WADA classification of diuretics and masking agents References Enhanced oxygen transfer 132 DAVID J. ARMSTRONG 9.1 Introduction Physiology Erythropoietin Blooddoping Blood substitutes Haemoglobin modifiers Actovegin Biological passports Conclusion References Prohibited methods: chemical and physical manipulation Current (2010) WADA regulations with respect to chemical and physical manipulation Prevalence of chemical and physical manipulation in sport Techniques for identifying chemical and physical manipulation References Gene doping 160 DOMINIC J. WELLS 11.1 Introduction Methods of genetic modification Genes that might enhance athletic Performance Methods ofdetection The practicalities and risks ofgene doping Summary Acknowledgements References 168

6 Contents xi 12 Stimulants History of stimulant use in sport Types of stimulants and their modes of action Stimulants and sport Stimulants and the WADA prohibited list References Narcotic analgesic drugs 193 PETER N. ELLIOTT 13.1 Introduction Pain and nociception Mechanism of action of narcotic analgesics Side effects of narcotic analgesics The use of narcotic analgesics in sport References Cannabinoids What are cannabinoids? History of cannabis in sport Cannabinoids in sport Cannabinoids and the WADA prohibited list References Glucocorticosteroids 207 PETER N. ELLIOTT 15.1 Introduction The functions and side effects of glucocorticosteroids Local steroid injections Other uses of glucocorticoids WADA regulations for the use of glucocorticosteroids References Alcohol 214 THOMAS REILLY 16.1 Introduction Anxiety and Performance 215

7 xii Contents 16.3 Metabolism of alcohol Action of alcohol on the nervous System Alcohol and health Alcohol andphysiological responses to exercise Alcohol in aiming sports Alcohol and sports accidents Overview References Betabiockers What are beta blockers? History of beta blockers in sport Beta blockers and the WADA prohibited list The use of beta blockers in sport References 242 SECTION 3 Substances and methods permitted in sport Supplements for high intensity exercise: creatine and other ergogenic aids 247 DON MACLAREN 18.1 Introduction Energy metabolism andfatigue Creatine Sodium bicarbonate Beta-alanine Conclusion References Supplement use in sport Introduction Extent of Supplement use Why Supplements are used Types of Supplements 264

8 Contents xiii 19.5 Availability of Supplements Problems associated with Supplement use Advice for athletes References Caffeine NEIL CHESTER Introduction 274 Pharmacology 275 Mechanisms of action 276 Performance-enhancing properties 278 Caffeine combinations 282 Therapeutic actions 284 Adverse side effects 284 Caffeine use and WADA regulations 285 Summary 288 References Over-the-counter stimulants and herbal preparations 294 NEIL CHESTER 21.1 Introduction Upper respiratory tract (URT) conditions and exercise Treatment of URT conditions Weightloss Relief from fatigue and drowsiness Sympathomimetic amines Methylxanthines OTC herbal stimulants Summary References Non-steroidal anti-inflammatory drugs 317 PETER N. ELLIOTT 22.1 Introduction The inflammatory response The treatment of sporting injuries References 332

9 xiv Contents 23 Melatonin and related substances THOMAS REILLY AND JIM WATERHOUSE Background Melatonin and biological rhythms Other properties of melatonin Exercise and the melatonin rhythm Melatonin and thermoregulation Melatonin andjet-lag Alternatives to melatonin: the benzodiazepines Overview References Hypoxie chambers and other artificial environments 354 DAVID J. ARMSTRONG 24.1 Introduction Exercise at altitude Adaptations to altitude WADA attitude to artificially induced hypoxic conditions Conclusion References 366 SECTION 4 The extent of doping in sport Prevalence of drug misuse in sport 3^ Introduction Statistics on doping control in sport Surveys into drug misuse in sport A perspective on the prevalence ofdrug misuse in sport through medical practitioners General discussion References 384 Appendix: Synopsis of drugs used in sport Index