KNES372 (Lectures-Final)

Not completed!

what is the WADA

World Anti-Doping Agency

where is the head office of the WADA

Montréal (2001)

how many times has the WADA code been revised

4 times

how many international mandatory standards are there and what are they

8

code compliance by signatories

education

prohibited list

therapeutic use exemptions

testing and investigations

laboratories

results management

protection of privacy and personal information

how many non-mandatory guidelines

12

guidelines for education

guidelines for results management

guidelines for therapeutic use exemptions

guidelines for privacy

guidelines for sample collection

guidelines for gathering information and sharing intelligence

guidelines for implementing an effective testing program

guidelines for sample collection personnel

hGH biomarkers test

TUE enquiries by accredited laboratories

conducting and reporting subcontracted and further analysis for doping control

gene doping detection (PCR)

what is CCES

canadian centre for ethics in sport (1995)

how many violations must occur

1 or more

is attempted use also a violation

yes

how many whereabouts failures result in a violation

3 in 12 months

is possession or trafficking indicative of a violation

yes

can a doping administrator be charged with a violation

yes

can an individual be guilty of a doping violation by association

yes

what is an example of a drug that is only banned in competition

ADHD medication

what is a potential problem for the future of doping in sport

gene doping

who was the whistleblower for Russian doping

Dr. Grigory Rodchenkov

what do beta-blockers do that make them prohibited in sport

lower HR and can increase stability

what are pharmacokinetics

how body affects the drug

what are pharmacodynamics

how drug affects the body

what is tylenol used for

pain and fever

what does NSAID stand for

non-steroidal anti-inflammatory drugs

what are NSAIDs used for

pain, fever, and anti-inflammatory

what is cortisone used for

pain and anti-inflammatory

what are opioids used for

acute and severe pain (limited use)

what can cannabinoids be used for

?use in chronic pain

what is the therapeutic window

comparing therapeutic effect of a drug to the toxic effect

what is the lower limit of the therapeutic window

the concentration the produces half the greatest possible effect

what is the upper limit of the therapeutic window

no more than 5-10% of patients experience a harmful side effect

what factors affect metabolism of drugs

genetic, environmental (enzyme induction or inhibition-drug interactions), physiological (age, liver disease, renal disease, nutrition, alcohol, smoking)

where is tylenol absorbed best

small intestine

where does tylenol metabolize and how

the liver; glucuronidation/sulfation

how long does tylenol take to “kick in” and what is its half life

10-60 minutes; 2-3 hours

how is tylenol eliminated

urine as metabolites

what does an overdose of tylenol result in physiologically

depletion of glutathione in the liver preventing the detoxification of metabolic intermediaries

where are NSAIDs absorbed

stomach and upper small intestine

what is the time to peak of NSAIDs

1-2 hours

where are NSAIDs metabolized

liver

how are NSAIDs excreted

urine

what is the half life of NSAIDs

2 hours

what are side effects of NSAIDs

nausea, pain, gastritis, ulcer, hypertension, fluid retention, renal failure, inhibited clotting, vasoconstriction, tinnitus

what potential implications to NSAIDs have for injury

inhibit protein synthesis, prevent muscle repair and regeneration, inhibit tenocyte proliferation and collagen formation, potentially impair bone healing

what are cortisone injections used for

bursitis, tenosynovitis, osteoarthritis

what are the contraindications for cortisone injections

infection, prosthetic joint, fracture

relative-anticoagulant, type 1 diabetes, TB, hemarthrosis, immunosuppression

what are possible ADRs for cortisone injections

damage to the cartilage or tendon, infection, post-infection flare, skin atrophy, tendon rupture, bleeding

what are opioids used for

pain relief (acute and chronic), sedation, anesthesia (spinal, epidural, intrathecal), cough, diarrhea, dyspnea

what are side effects on opioids

nausea, dizziness, constipation, sedation, confusion

what can opioid overdose cause and what is used in the event of an overdose

respiratory depression; naloxone (narcan) kits

which component of cannabinoids is psychoactive

THC

what type of absorption of cannabinoids results in lower peak concentrations and slower onset

oral

where are cannabinoids distributed in the body

fatty tissues (up to 33 days after use)

where are cannabinoids metabolized

the liver

what is the main form of cannabinoid elimination

feces

what are indications for cannabinoid use

chemo-induced nausea/vomiting, spasticity, neuropathic/cancer pain, seizures, wasting syndromes (HIV/AIDS, cancer)

is there evidence cannabinoids support acute pain

no

what are the acute effects of cannabinoids

sedation, dizziness, sensory disturbance, hallucination/paranoia, euphoria, dysphoria, anxiety, cognitive impairment, hypotension, tachycardia, hyperemesis

what are chronic adverse effects of cannabinoid use (correlation)

anxiety, depression, psychosis/schizophrenia, cognitive impairment, lung disease, carcinogenicity

what is an iron deficiency

depletion of body’s iron stores and restriction of iron supply

what does an iron deficiency cause cellularly

reduction in oxygen transport capacity, reduction in oxidative capacity at cellular level

what is the lifespan of an RBC

120 days

where are RBCs formed

in the bone marrow

what is ferritin

iron-storage protein

what is transferrin

iron-binding protein that transports iron in the blood with ferritin

what is hemoglobin

iron-containing protein that carries oxygen and returns carbon dioxide

what is myoglobin

iron-containing protein in muscles that transports oxygen to mitochondria of muscle cells

how is iron stored in men compared to women

female-45mg/kg

male-55mg/kg

what is pre-latent iron deficiency

depleted iron stores but normal hemoglobin

what is latent iron-deficiency

impaired erythropoiesis, decreased transferrin saturation and normal hemoglobin

what is anemia

hemoglobin synthesis falls, low ferritin and hemoglobin

how many micrograms/L of ferritin is cause for investigation

less than 30

what is considered low levels of hemoglobin

female-less than 120g/L

male-less than 130/L

what are symptoms of iron deficiency

fatigue, poor athletic performance, weakness, pale, light-headedness, cold hands and feet, fast heartbeat, shortness of breath

what factors contribute to iron deficiency risk in athletes

endurance athletes, athletes with EDs, vegetarians, medical conditions

why can exercise cause iron-loss

hemolysis, hematuria, sweating, GI bleeding, injuries

what vitamin can aid in iron absorption

vitamin C

how much more iron do athletes need

30-70% more iron

what was the female athlete triad model

involved energy availability, menstrual function, and bone health

what replaced the female athlete triad

relative energy deficiency in sport (RED-S)

what is RED-S

a broader term involving impaired physiological function caused by energy deficiency

is disordered eating a clinical diagnosis

no

where is a greater prevalence of DE and EDs

athletes in weight sensitive sports, female athletes, athletes in general

what is eumenorrhea

regular cycles

what is primary amenorrhea

no periods by the age of 15

what is secondary amenorrhea

absence of 3 or more consecutive cycles after the onset of menstruation

what is oligomenorrhea

menstrual cycle length greater than 35 days (45 days for adolescents)

what is functional hypothalamic amenorrhea

type of secondary amenorrhea

what athletes are at higher risk of low energy availability

cycling, rowing, running, ski jumping, weight class sports

what are common pathogens

viruses (influenza), bacteria (strep throat), fungi (tinea), parasites (malaria)

how is a virus treated

antivirals are used if necessary, antiretroviral (HIV)

what form of pathogen is tetanus considered

bacterial

how are bacterial infections treated

antibiotics if needed, entire course must be finished even if feeling better

how are fungi infections treated

antifungals

what parasites can cause infection in humans

protozoa (giardia), helminths (roundworm), ectoparasites (ticks, lice, mites)

how are parasites treated

antiparasitics

what infections are transmitted by direct contact

common cold, mononucleosis

what infection is transmitted by indirect contact

norovirus

what infection is transmitted by droplets

influenza

what infection utilizes airborne transmission

TB, measles

what infection requires a vehicle for transmission

E. Coli, norovirus

what infection is vector-borne

malaria, lyme disease

what are general symptoms and signs of an infective disease

fever, diarrhea, fatigue, muscle aches, coughing

when should a person see a doctor

animal bite, cough for more than a week, breathing problems, sever headache with fever, rash or swelling, prolonged or unexplained fever, sudden vision problems