Performance Enhancement

There follow illustrations of the mechanisms by which drugs can enhance performance in various sports; naturally, these are proscribed by the authorities (International Olympic Committee (IOC) Medical Commission, and the governing bodies of individual sports).

10 Bass M 1970 Sudden sniffing death. Journal of the

American Medical Association 212: 2075.

For 'strength sports' in which body weight and brute strength are the principal determinants (weight lifting, rowing, wrestling): anabolic agents, e.g. clenbuterol (P-adrenoceptor agonist), andro-stenedione, methandienone, nandrolone, stanozolol, testosterone. Taken together with a high-protein diet and exercise, these increase lean body weight (muscle) but not necessarily strength. It is claimed they allow more intensive training regimens (limiting cell injury in muscles). Rarely, there may be episodes of violent behaviour, known amongst athletes as 'roid [steroid] rage'.

High doses are used, with risk of liver damage (cholestatic, tumours) especially if the drug is taken long-term, which is certainly insufficient to deter 'sportsmen'. They may be more inclined to take more seriously the fact that anabolic steroids suppress pituitary gonadotrophin, and so testosterone production.

Growth hormone (somatrem, somatropin) and corticotrophin use may be combined with that of anabolic steroids. Chorionic gonadotrophin may be taken to stimulate testosterone production (and prevent testicular atrophy). Similarly, tamoxifen (antioestrogen) may be used to attenuate some of the effects of anabolic steroids.

For events in which output of energy is explosive (100 m sprint): stimulants, e.g. amphetamine, bro-mantan, carphendon, cocaine, ephedrine and caffeine (>12 mg/1 in urine). Death has probably occured in bicycle racing (continuous hard exercise with short periods of sprint) due to hyperthermia and cardiac arrhythmia in metabolically stimulated and vaso-constricted subjects exercising maximally under a hot sun.

For endurance sports to enhance the oxygen carrying capacity of the blood (bicycling, marathon running): erythropoietin, 'blood doping' (the athlete has blood withdrawn and stored, then transfused once the deficit had been made up naturally, so raising the plasma haemoglobin above normal).

For events in which steadiness of hand is essential (pistol, rifle shooting): ยก3-adrenoceptor blockers. Tremor is reduced by the P2-adrenoceptor blocking effect, as are somatic symptoms of anxiety.

For events in which body pliancy is a major factor (gymnastics): delaying puberty in child gymnasts by endocrine techniques.

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