DRUGS AND USUAGE IN ORGANIZED SPORTS EVENTS

BACKGROUND-

Today, sports events are competitive and sportsman and atheletes are very well compensated.
Some sportsman try to improve their performance and excel over the others,by better training
and at times,by using, other means.

Performance enhancing drugs are available and can be consumed to enhance their
physical abilities and alter body metabolism, thereby giving them certain unfair advantage over the
others who do not use the same.

This has been a matter of deep concern to World Sports Regulatory authorities.Various articles
and publication are available on the subject, and the Information has now become a common
knowledge.

It is therefore felt important that all persons who are members of the Health Care Team in Private
and Public Health should become aware of this. The compilation, listed below is meant to serve
the objective. 

BANNED DRUGS-

Some of drugs are banned from the Olympics by the world Anti-Doping Agency in 1999 to
deal with the increasing problem of doping in the sports world.

The banned substances fall into different categories and are listed below-

BLOOD DOPING-

Blood doping is the injection of red blood cells , related blood products that contain red cells
or artificial oxygen containers.

This is done by extracting and storing ones own blood prior to an atheletic competition, well
in advance of the competition so that body can replenish its natural levels of red blood cells,
and subsequently injecting the stored blood immediately before the competition. This results
in unnatural level of red  blood cells which improves oxygen transport and  atheletic endurance,

This is prohibited in most events   

BANNED ANDROGENIC AGENTS-

Banned androgenic agents are either 

1.ANABOLIC STEROIDS  which increase testosterone and epitestosterone, thereby improve
 muscle strength and endurance

2. OR BETA-2-AGONISTS-
Can act as bronchodilators and increase heart rates, in addition to their mild androgenic effects.

BANNED ANABOLIC STEROIDS-

Andro,
DHEA, (dehydroxyepiandrosterone)
Stanozol
Testosterone and nandrolone or derivatives

BANNED ANDROGENIC AGENTS- 

Bambuterol                                  
Clenbuterol                                   
Salbutamol                                   
Tibolne
Zeranol
Zilpaterol
Selective androgen receptor modulators( SARMs)

Few of the banned drugs are Endogenous, that is normally produced in the Human body.
Most  of banned drugs are Exogenous drugs chemically produced

EXOGENOUS ANABOLIC ANDROGENIC STEROIDS-

List of Banned exogenous ( non-natural ) androgenic steroids banned as of January 2012

 1- Androstenediol                                              Methasterone
 1-Androstenedione                                            Methidienolone
 Bolandiol                                                            Methyl-1- testosterone
 Bolasterone                                                        Methylnoresterone
 Boldenone                                                          Methytestosterone
 Calusterone                                                        Metribolone
 Clostebol                                                            Mibolerone
 Danazol                                                              Nandrolone
 Dehydrochlormethyltestetosterone                 19-Norandrostenedione
 Desoxymethyltestosterone                               Norboletone
 Drostanolone                                                      Norclostebol
 Ethylestrenol                                                       Norethandrolone
 Fluoxymesterone                                                Oxabolone
 Formebolone                                                      Oxandrolone
 Furazabol                                                            Oxymestrone
 Gestrinone                                                           Oxymetholone
 4-hydroxtestosterone                                          Prostanozol                                                                    
 Mestanolone                                                        Quinobolone
 Mesterolone                                                         Stanozolol
 Metenolone                                                          Stanbolone
 Methandienone                                                   1-Testosterone
 Methadriol                                                            Tetrahydogestrinone
                                                                                Trenbolone

Drugs with similar structure and biological activity are also banned because new designer drugs
of this sort are always being deveoped inorder to beat the drug tests.

ENDOGENOUS ANABOLIC ANDROGENIC STEROIDS-

Androstenediol
Androstenedione
Dihydrotestosterone
Prasterone ( dehydroepiandrosterone DHEA)
Testosterone

OTHER ANABOLIC AGENTS-

Clenbuterol
Selective andrrogen receptor modulators (SARMs)
Tibolone
Zeranol
Zilpaterol

HORMONES AND RELATED SUBSTANCES-

Certain peptide hormones increase bulk, strength, and oxugen-carrying red blood cells

ERYTHROPOIESIS -STIMULATING AGENT

The following Erythropoiesis -stimulating agents are BANNED

Erythopoietin (EPO )
Darbepoetin (dEPO)
Hypoxia -inducible factor (HIF )
Stabilizers ,Methoxyploythene glycol-epoetin beta (CERA)
Peginesatide (Hematide )
Growth hormones (hGH )
Insulin like growth factors (IGF-1 etc. )
Fibroblast growth factors (FCFs)
Hepatocyte growth factors (HGF)
Mechano growth factors (MGFs)
Platelet -derived  growth factors (PDGF)
Vascular endothelial (VEGF )
Chronic gonadotropin ( banned in men only)
Somatropin ( growth hormone )
Insulins and cortocotrophins,
Corticomimics and their releasing factor

BETA-2-AGONISTS

All beta-agonists and their D-isomer and L-isomer are banned
However,
Formoterol
Salbutamol
Salmetrol
Terbutaline

May be used with a- (therapeutic use exemption ) ONLY IN INHALED FORM

STIMULANTS-

Stimulants direcly affect the central nervous system including blood flow and heart rate.

Stimulants which are banned include-

Amphetamine
Beta-2-agonists
Ephedrine
Pseudoephedrine
Fencamfamine
Cocaine
Methamphetamines
Mesocab
and other substances with similar structure and biological effects 

DIURETICS AND MASKING AGENTS-

Diuretics which increase the production of urine, and masking agents , chemical compounds,
which interfere with the drug tests are banned for two reasons-

1. by decreasing water retention and thus decreasing an atheletes weight , an important
    consideration used in sports

2. increased urine depletes the concentration of both banned drugs and their metabolites.
    making their determination more difficult.

Masking agents work by making drug tests ineffective leading to false and negative results

Desmopression
Plasma expanders ( glycerol, intravenous  administration of albumin, dextrin, hydroxyethyl starch
and manitol )
Probenecid
other substances with similar biological efects are also banned
Local application of felypresin  in dental anethesia is not prohibited

DIURETICS-

The following diuretics are banned

Acetozolamide                           Furosemide
Amiloride                                    Hydrochorthiazide
Bendoflumethizide                     Indapamide
Butemide                                     Metozolamide
Chlorthalidone                            Spironolactone
Chlothiazide                                Triamterene
Ethacrynic acid                         

NARCOTICS AND CANNABINOIDS-

Narcotics analgesics decrease the sensation of serious injuries , allowing atheletes to
coninue training for competition after serious injuries.

While pain killer are allowed , including codeine, the following are banned-

Buprenophine                                        Oxycodone
Dextromramide                                      Oxymorphine
Diamorphine ( heroin )                          Pentazocaine
Fentanyl and its derivatives                 Pethidine
Methadone
Morphine

GLUCOCORTICOIDS-

Glucocorticoids are a class of corticoids that affect the metabolisim of carbohydrates, fat,
and proteins and regulate glycogen and blood pressure levels. 

These possess profound anti-inflammatory activity and cause alteration of connctive tissue
response to injuries.

The anti-inflammatory and connective tissue effects of glucocorticoids might mask injuries,
leading to more serious injury to athletes.

Because of this and metabolism regulation effects , the administration of any  glucocorticoids
orally , rectally , intravenously, or intramuscularly  is prohibited and requires therapeutic use
exception.

Topical use of glucocorticoids does not require exemption.

BETA-BLOCKERS-

Beta-blockers are prohibited during competition in a number of sports, out of competition,
they are only prohibited in archery  and shooting

The prohibited Beta- blockers include-

Acebutol                                        Carvedilol                           Nadalol
Alprenolol                                      Celiprolol                           Oxyprenol
Atenolol                                          Esmolol                              Pinodol
Betaxolol                                        Labetalol                            Propranol
Bisoprolol                                       Levobunaolol                    Salatol
Bunolol                                           Metipranolol                       Timolol
Cartelol                                           Metoprolol

 PRESCRIPTION MEDICINES AND COMPETITIVE SPORTS EVENTS -STATUS

LIST (MIMS)

1.  ACETOZOLAMIDE -            Restricted/ Banned    
 2. ANASTRONE-                     Female only Permitted
3. ATENOLOL -                         Restricted /Banned
4. BETAMETHASONE -           Restriced/Banned
5. BETAXOLOL-                        Restricted /Banned
6. BISOPROLOL -                     Restricted /Banned
7. BUDOSENIDE-                     Restricted/Banned
8. BUPRENOPHRINE-             Restricted /Banned
9. BUTORPHANOL-                 Restriced /Banned
10. CARVEDIOLOL-                 Restriced /Banned
11.CETRORELIX -                    Restriced /Banned
12.CICLESOMIDE -                  Restricted/Banned
13.CLOMIPHENE CITRATE -  Female only Permitted
14. CLONIDINE -                      Restricted/ Banned
15. CLOPAMIDE -                     Restricted/Banned
16. DANAZOL -                         Restricted/Banned
17. DEFLACORT-                     Restricted/ Banned
18. DEXAMETHASONE -         Restricted/ Banned
19.DEXTRAPROPOXYPHENE- Restricted/ Banned
20. DOBUTAMINE-                   Restricted/Banned
21. EPHEDRINE-                       Restricted/Banned
22. EPLERENONE-                   Restricted/Banned
23. EPOETIN ALFA-                  Restricted/Banned
24. ERGOTAMINE-                   Restricted/Banned
25. ESMOLOL-                           Restricted/Banned
      ETHINYL  OESTRADIOL -  Restricted/Banned
26. ETOPHYLLINE-                   Restricted/Banned
27. EXENATIDE-                       Restricted/Banned
28. FENTANYL-                         Restricted/Banned
29. FRUSEMIDE-                      Restricted/Banned
30. HUMAN CHORIONIC GONADOTROPIN-       Females only
31. HUMAN PURIFIED INSULIN-     Restricted/Banned
32  HYDROXYCHLOR-
     
33. HYDROXYZINE-                             Restricted/Banned 
34. INDAPAMIDE-                             Restricted/Banned
35. ISOPRENALINE-
36. INSULIN LISPRO-                       Restricted /Banned                       
37. INSULIN GLARINE-                     Restricted/Banned
37. INSULIN DETERMIR-                  Restricted/Banned
38. LANTANOPROST-                    Restricted/Banned
39 .LETROZOLE-                               Female use only
40. MECLIZINE-                                 Restricted/Banned
41. MESTERONE-                             Restricted/Banned
42. METOPROLOL-                           Restricted/Banned
43. METHYL PREDNISOLONE-       Restricted/Banned
44. METHYL TESTASTERONE-      Restricted/Banned
45. MORPHINE SULPHATE-            Restricted/Banned
46. NANDROLONE-                           Restricted/Banned
47. NEBIVOLOL-                                Restricted/Banned
48. NOSCAPINE-                               Restricted/Banned
49. PINDOLOL-                                  Restricted/Banned
50. PENTOZOCAINE-                       Restricted/Banned
51. PHENYL EPHEDRINE-              Restricted/Banned
52. PROPOXYPHENE-                     Restricted/Banned
53. PROPRANOLOL-                        Restricted/Banned
54. PREDNISOLONE-                      Restricted/Banned
55. PSEUDOEPHEDRINE-
56. RESERPINE-
57. SABUTAMOL -                            Restricted/banned - Except Inhaler
58. SAMETEROL
59. SELEGININE-
60 .SOMATROPIN-
61.SPIRONOLACTONE-
62.STANOZOLOL-
63.TAMOXEFEN -                             Female only permitted
64.TERBUTALINE-
65.TESTOSTERONE-
66.THEOPHYLLINE-
67.TIBOLONE-
68.TIMOLOL-
69.TORASEMIDE-        
70.TRIAMCINALONE-
71.UROKINASE
72. XIPAMIDE