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