Non conventional using drugs

By: Dr Vahedi

Lifestyle drugs

• An eclectic group of drugs that are used for non- medical purposes

• Including :• A) Drugs of abuse• B) Cosmetic purposes or for purely social reasons• C) Enhance athletic or other performance

Lifestyle drugs & medicines , excluding drugs in sport

“lifestyle use”

Primary clinical use

Example Category

Erectile enhancment

Erectile dysfunction

sildenafil Medicines approved for specific indication but that can also be used for other lifestyle purposes

Regrowth of hair

HTN minoxidil Medicines approved for specefic indications that can also be used to satisfy “lifestyle choices” or to treat

“lifestyle disease”Cosmetic alteration

Relief of muscle spasm

Botulinum toxin

Drugs have slight or no current clinical use but which fall into the lifestyle category

Recreational usage

Non as such MDMA, Ecstasy

Drugs that have no clinical utility but which are used to satisfy lifestyle requirements

Widespread for many conditions

non Herbal preparation

Natural products,largely unregulated with claim effects but which cater to lifestyle needs or desires

Enhance athletic or other enhance performance drugs

• 1) Anabolic Agents• 2) Hormones and related substances• 3) β2 –Adrenoceptor agonists• 4) β- Adrenoceptor antagonists• 5) Stimulants• 6) Diuretics• 7) Narcotic analgesics

Drugs in sport• Anabolic agents Androgenic steroids ( Testosteron, Nandrolone,…) Effects : Increase Muscle development Muscle mass & improve sporting performance↑ Muscle strength ? Increase aggression and competitivness serious long term side effects

Drugs in sport

• Other Anabolic Agents :Clenbuterol: ( Anabolic androgenic + agonist action on β2 adrenoceptors)

selective androgen receptor modulators (SARMs) : aryl propionamid analogs Bicyclic hydantoein analogs

tibolone ( estrogen activity +weak androgenic activity)

Drugs in sport Hormones and related substances

EPO : Increased erythrocyte formation & increased oxygen

transport & blood viscosity Side effects: CAD, Strokes (trombos formation) , HTN

Human growth hormone: Effects: ↑lean body mass , ↓fat , accelerate recovery ,

cardiac hypertrophy,acromegaly, liver damage, ↑cancer risk

Drugs in sport Hormones and related substances

• Insulin: To promote glucose uptake and enegy

production in muscle Probably ineffective in improving

performance Side effect: hypoglycemia

Drugs in sport Hormones and related substances

• Other related substances:

Chorionic Gonadotrophin (CG) and Luteinizing Hormone (LH) in male

Corticotrophins

Insulin-like Growth Factor-1 (IGF-1)

Drugs in sport• β2 –Adrenoceptor agonists (Exp: Salbutamol

formoterol, salmeterol )Used by Runners, swimmers .Mechanism: ↑O2 uptake and transport

(Bronchodilation) cardiac function , Controlled studies show no improvement performance

• β- Adrenoceptor antagonists (Exp: propranolol) used to reduce tremor and anexity in precision sports

(Shooters, ski jumpers, archery)Negative effect on endurance Depression, bronchospasm, fatigue

Drugs in sport• Stimulants:Ephedrine , methylephenidate, fenfluramine,

cocaein, amiphenazole , strychnine ,taurineEffects: Some trials have shawn ; to improve performance in spriting,

weightlifting. Increase muscle strengh and reduce muscle fatigue Surprisingly Caffeine apears to be more effective in improving

muscle performance than other more powerful stimulants. Several deaths with taking amphetamines &ephedrine – like drugs

Drugs in sportStimulants:

– AmphetaminesDelay fatigue, increase alertness, enhance

speed, power, endurance, concentrationSide effects: Hypertension, angina, vomiting, abdominal

pain, cerebral hemorrhage, dependence, death

Drugs in sportStimulants:

– CaffeineShortened reaction time, improved concentration,

diuresis Primary theory is enhanced release of FFA,

sparing glycogen. Stimulate the release of Ca2+ in muscle cells

Glycogen sparing leading to delayed fatigue> 12 ug/mL is a positive urine per IOC

Side effects:Dyspepsia, cardiac damage, combination with other

stimulants (e.g. ephedrine) may be fatal

Drugs in sport

Diuretics: Rapid weight loss also to mask presence of other agent in urine by

dilution– Overall negative impact on performance– Dehydration, hypotension, muscle cramps,

electrolyte imbalance Narcotic, analgesics: used to mask injury- associated pain Increased risk of further injury, dependence,

drowsiness, mental clouding; in high doses: respiratory depression, hypotension

CONCLUSION

Mechanism enhance performance drugs

PHYSIOLOGICAL REASONS

Lose weight, train harder

Mask injury and reduce

tiredness

To build muscle,

increase energy

Increase oxygen

transport

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