1 1 المنشطات و أضرارها performance enhancing drugs
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المنشطات و المنشطات و أضرارهاأضرارها
PERFORMANCE ENHANCING DRUGS
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Athletic or Performance-Related Fitness
AgilityBalance or equilibriumCoordinationPowerReaction timeSpeed or velocity
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PERFORMANCE ENHANCING DRUGS
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Performance-Enhancing DrugsAnabolic Steroids
Description Drugs derived from testosterone and approved for medical use, but often used by athletes to increase musculature and weight.
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Performance-Enhancing DrugsAnabolic Steroids
Claims May enhance performance and improves physical appearance.
Reported to increase lean muscle mass, strength, and the ability to train longer and harder.
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Performance-Enhancing DrugsAnabolic Steroids
Risks Liver tumors, jaundice, fluid retention, high blood pressure, severe acne, aggression and other psychiatric side effects.
Men: Shrinking testicles, reduced sperm count, infertility, baldness, and development of breasts.
Women: growth of facial hair, changes in or cessation of the menstrual cycle, enlargement of the clitoris, and deepened voice.
7Table 5-3, p.126
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Androstenedione produced by:1- the ovary, testes, and the adrenal cortex,
2-is a prohormone for both estrogen and testosterone..
3- Androstenedione supplementation has become popular with male athletes because they believe they will be more powerful.
4-Research shows no measureable effect on free or total testosterone,
5-but HDL levels dropped and plasma estrogens rose.
6- No measurable effect has been noted on athletic performance.
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GYNECOMASTIA
These pictures are the “BEFORE” (left) and “AFTER” (right) pictures of a man that had surgery to correct his case of gynecomastia. I’m sure he thought “It won’t happen to me.” as well! Think about it before you choose to take P.E.D.!
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Performance-Enhancing DrugsAndrostenodione
Claims Improves testosterone concentration, increases muscular strength and mass, helps reduce body fat, enhances mood,
and improves sexual performance.
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Performance-Enhancing DrugsAndrostenodione
Risks Breast enlargement, increased risk of cardiovascular disease and pancreatic cancer in men, acne, male pattern baldness, and a decrease in “good” (HDL) cholesterol.
In women, high testosterone levels can cause increased body hair, deepening of the voice, and other male characteristics.
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RISKS OF P.E.D.
Steroid induced acne
Anti-hypertensive behaviors
Hypertension or fatigue
Chronic gonadotrophin
Increased level of female hormones in a man’s body
Testicular atrophy
Induced gynecomastia
Presence of abnormally large breasts in men
Increased use of other drugs to mask symptoms
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SYMPTOMS OF P.E.D. USERapid weight gain with larger
muscle massAggressiveness Jaundice/Skin color changePurple or red spots on bodySwelling of feet and legsShaking and/or tremblingPersistent body odorsSevere acne breakouts with
abnormally oily skin
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DOES THIS LOOK APPEALING TO YOU?
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CNS Stimulants
CRACK
METHAMPHETAMINE
COCAINE
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StimulantsDescription: A group of synthetic or plant-
derived drugs that increase alertness and arousal by stimulating the central nervous system.
Medical Uses: Short-term treatment of obesity, narcolepsy, and hyperactivity in children No medical use for methamphetamine
Method of Use: Intravenous, intranasal, oral, smoking
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Types of Stimulant Drugs 1- Cocaine Products
Cocaine Powder (Generally sniffed, injected, smoked on foil)
“Crack” (smoked)
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Types of Stimulant Drugs2- Amphetamine Type Stimulants
(ATS)
Amphetamine “Speed”Dexamphetamine “Ice”Methylphenidate “Crank”Methamphetamine “Go Fast”
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Methamphetamine vs. CocaineCocaine half-life: 1-2 hours
Methamphetamine half-life: 8-12 hours
Cocaine and the amphetamines have very similar effects on mood, patterns of abuse, the type of dependence produced, and their toxic effects.
Cocaine paranoia: 4 -8 hours following drug cessationMethamphetamine paranoia: 7-14 days
Methamphetamine psychosis - May require medication/hospitalization and may not be reversible
Neurotoxicity: Appears to be more profound with amphetamine-like substances, rapid formation of lesions
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Acute Stimulant Effects
PsychologicalIncreased energyIncreased clarityIncreased competenceFeelings of sexualityIncreased sociabilityImproved moodPowerful rush of euphoria -
freebase and intravenous only
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Acute Stimulant EffectsPhysicalIncreased heart rateIncreased pupil sizeIncreased body temperatureIncreased respirationConstriction of small blood vesselsDecreased appetiteDecreased need for sleepNumbness of nasal mucosa - intranasal only
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Chronic Stimulant EffectsPhysicalWeight loss/anorexiaSleep deprivationRespiratory system diseaseCardiovascular diseaseHeadachesSevere Dental diseaseNeedle marks and abscesses - intravenous onlySeizureAgitation and violence
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Crystalline white powder Snorted in “lines” of 10-35 mg eachAdulterated w cheap local anesthetics,
stimulants, and inert white powdersYields moderate to high blood levelsGradual onset of effects at 15-20 min
with peak at 30-60 min
Cocaine Hydrochloride
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Soluble in waterPeak blood levels achieved instantaneouslyRapid onset, brief duration, intense “crash”Rapid development of compulsive use
pattern“Speedball” when mixed with heroin to
cushion the “crash”
Cocaine Hydrochloride: Intravenous Administration
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Increases the synaptic concentration of dopamine and Norepinephrine by preventing its reuptake
Dopamine agonists/replacements have not proved therapeutically useful in addicts
Cocaine: Mechanism of CNS Action
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Their Brains
have been
Re-Wired by Drug Use
Their Brains
have been
Re-Wired by Drug Use
Because…Because…
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Partial Recovery of Brain Dopamine Transporters in Methamphetamine
(METH)Abuser After Protracted Abstinence
Normal Control METH Abuser(1 month deter)
METH Abuser(24 months detox)
0
3
ml/gm
Source: Volkow, ND et al., Journal of Neuroscience 21, 9414-9418, 2001.
Hint: Ask about free radicals!
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Euphoric moodIncreased energy, alertnessIncreased sexualityParanoiaIncreased heart rate, blood pressure
Cocaine: Acute Effects
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Lethargy, fatigueReduced attention spanSexual dysfunctionDepression, irritability, anhedoniaParanoid psychosis
Cocaine: Chronic Effects
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Cardiac arrhythmias, fibrillationHyperthermia- > 106º FConvulsions, loss of consciousnessRespiratory & cardiac arrestAbruptio placentae (miscarriage)Fatal reactions rare, but unpredictable
Cocaine: Toxic Reactions
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Rebound dysphoria Agitation, restlessnessIntensifies with dosage & chronicity of useCravings & drug-seeking behaviorAbuse of alcohol & other drugsSuicidal ideation, behaviorOften followed by prolonged sleep
Cocaine “Crash”
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Cocaine/Amphetamines“The Runs”
DRUG TAKING CRAVING
DRUG TAKING
DRUG TAKING
CRAVING
CRAVING
The BluesFATIGUEDEPRESSIONHYPERPHAGIA
CRASH
DRUG TAKING
sleep
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Speed Methamphetamine powder
ranging in color from white, yellow, orange, pink, or brown
Color variations are due to differences in chemicals used to produce it and the expertise of the cooker
Other names: Crystal, Crystal Meth, Crank, Go Fast, Zoom
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IceHigh purity
methamphetamine crystals or coarse powder ranging from translucent to white, sometimes with a green, blue, or pink tinge color
Depends on additives and filtering
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Cardiac Disorders and Methamphetamine
Coronary SyndromesArrhythmiaCardiomyopathyHypertensionValvular Disease
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Neurologic Disorders and Methamphetamine UseHeadacheSeizureCerebrovascular
Ischemic strokeCerebral hemorrhageCerebral vasculitis
Cerebral edema
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Respiratory Disorders and Methamphetamine UsePulmonary edemaBronchitisPulmonary hypertensionCOPD
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Formication
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Formication
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Source: The New York Times, June 11, 2005.Source: The New York Times, June 11, 2005.
“METH Mouth”“METH Mouth”
METH Use Leads to Severe Tooth Decay!
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MethamphetaminePsychiatric Consequences
Paranoid reactionsPermanent memory lossDepressive reactionsHallucinationsPsychotic reactionsPanic disordersRapid addiction
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Methamphetamine Psychosis Inpatients
Psychotic symptom Lifetime Current
Persecutory delusionAuditory hallucinationsStrange or unusual beliefsThought readingVisual hallucinationsDelusion of referenceThought insertion or made actNegative psychotic symptomsDisorganized speechDisorganized or catatonic behavior
130 (77.4)122 (72.6)98 (58.3)89 (53.0)64 (38.1)64 (38.1)56 (33.3)
35 (20.8)75 (44.6)39 (23.2)27 (16.1)38 (22.6)20 (11.9)18 (10.7)36 (21.4)19 (11.3)14 (8.3)
No. of patients having symptoms(%)
Srisurapanont et al., 2003
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THERAPEUTIC DRUGS
DiureticsRapid weight loss
Boxing, wrestling, judo
Excretion or dilution of illegal substances
Overall negative impact on performance
Dehydration, hypotension, muscle cramps, electrolyte
imbalance
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THERAPEUTIC DRUGS
OpioidsPrescription pain killers most common
Allow performance while injured
75% used after injury only
Increased risk of further injury, dependence,
drowsiness, mental clouding; in high doses: respiratory
depression, hypotension
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THERAPEUTIC DRUGS
Beta-BlockersAnti-tremor, anxiolytic effect
Shooters, ski jumpers, archery
Negative effect on endurance
Depression, bronchospasm, fatigue
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PERFORMANCE ENHANCING DRUGS
Peptide hormones: HCG
Increases testosterone
Maintains testicular volume with anabolic
steroid use
Ovarian cysts
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PERFORMANCE ENHANCING DRUGS
Pituitary and synthetic gonadotropinsIncreases testosterone, anti- estrogenicOvarian cysts
CorticotropinsIncrease testosteroneRare and related to excess corticosteroids-
pituitary suppression, immunity, osteoporosis, hyperglycemia
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PERFORMANCE ENHANCING DRUGS
Growth hormone
Increase muscle mass & decrease fat mass
Gigantism, acromegaly, hypothyroidism,
cardiac disease, myopathies, arthritis, diabetes
mellitus, impotence, osteoporosis
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PERFORMANCE ENHANCING DRUGSErythropoietin (EPO)
Stimulates RBC productionIncreases oxygen carrying capacityCVAs
Blood dopingRBC transfusion, artificial oxygen carriersIncreases oxygen carrying capacityAllergic reactions, sludging of blood
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FOOD SUPPLEMENTS
76-100% of athletes use vs. 50% general
population
May or may not contribute to enhanced
performance
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WHAT DO WE HAVE IN COMMON?
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Questions?