Drugs athletes are using to enhance performance

As a nutritional support pharmacist, you will be asked more about medications that athletes use to improve performance...

Anabolic hormones are still big, designer steroids (THG aka tetrahydrogestrinone or "the clear" or "the cream"), prescribed drugs (testosterone, danazol, etc) and even veterinary steroids (boldenone, stanozolol, etc). Some try human growth hormone or even insulin. Hormone antagonists such as tamoxifen counter estrogenic effects of anabolic steroids.

Erythropoiesis-stimulating agents (EPO, Mircera, etc) increase endurance, but they can be hard to detect. Stimulants (amphetamines, etc) are banned in college. Even excessive caffeine can get an athlete into trouble. But the NCAA does NOT ban phenylephrine and pseudoephedrine. These are often used legitimately and probably don't help performance.

Beta-blockers are used to steady the hands in archery, etc. Beta-agonists enhance oxygen uptake and large doses can be anabolic. Clenbuterol, or "Clen," for horses is popular because it's 100 times more potent than albuterol. Phosphodiesterase inhibitors (Viagra, etc) are used to increase oxygen supply by causing vasodilation in the lungs. Diuretics and others are used to "make weight" or try to mask illegal substances by increasing their elimination. The supplement colostrum is hot right now. It has growth factors and is used to try to increase strength and immunity.

References

  • Dhar R, Stout CW, Link MS, Homoud MK, Weinstock J, Estes NA 3rd. Cardiovascular toxicities of performance-enhancing substances in sports. Mayo Clin Proc. 2005 Oct;80(10):1307-15. doi: 10.4065/80.10.1307. Available at: https://pubmed.ncbi.nlm.nih.gov/16212144

    Alaranta A, Alaranta H, Helenius I. Use of prescription drugs in athletes. Sports Med. 2008;38(6):449-63. Available at: https://pubmed.ncbi.nlm.nih.gov/18489193

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