DOPING IN

SPORT
Prepared by
Ass. Prof. Eiman Hegazi

Presented By
Prof. Safaa El-Shanawany
Department of Forensic Medicine and Clinical Toxicology
 Learning
objectives:
• Define the nature and major
classes of doping agents.
• Identify sources and modes of
exposure.
• Recognize the toxic effects of
doping agents.
 Definition
• In sports, doping refers to the use
of performance-enhancing drugs,
particularly those that are
forbidden by the organizations that
regulate competitions.
 Ethics
• Doping contravenes the ethics of
both sport and medical science.
• Not only is doping in sport against all
principles of fair competition, it can
also be dangerous to an athlete's
health.
 Networks

•Athletes may obtain drugs

through three main
networks:
• Their physician
• The black market
• The proximity network
 Banned
Substances and
Methods
 New list of banned substances and methods
I. List of banned substances
A. Stimulants
B. Narcotics, both natural and synthetic
C. Anabolic agents
D. Diuretics
E. Peptide and glycoprotein hormones and analogues

II. Banned methods

A. Blood doping
B. Pharmacological, chemical or physical manipulation

III. List of substances under restriction

A. Alcohol
B. Marijuana
C. Local anesthetics
D. Corticosteroids
E. Beta-blockers
 Molecular weight
• All natural or synthetic doping drugs have a
common physical and chemical
characteristic, which is low molecular weight
(under 500). They can thus be detected by
the usual analytical methods, such as gas
chromatography, together with mass
spectrometry.
 Stimulants
• The most common group abused in
sports (amphetamine, ephedrine and
pseudo ephedrine)
• They stimulate the nervous system
and increase cardiovascular activity:
• Reducing tiredness
• Reducing muscle fatigue
• Enhancing aggression and
competitiveness
 Narcotics
• They do not enhance performance, they may
even impair it
• They are used to reduce pain and enable
athletes to continue even in presence of injury
• They are highly addictive and are prohibited
based on their illegal use
 Anabolic Agents

• They include:
• Androgenic steroids (nandrolone,
oxandrolone, testosterone)
• Beta-2-Agonists (salbutamol,
clenbuterol)
 Anabolic Androgenic
Steroids
• The use of androgens and anabolic
agents has become increasingly
widespread over the past 20
years, especially with the
development of synthetic anabolic
agents whose anabolic power is 30
to 50 times higher than that of
natural androgens.
 Anabolic Androgenic
Steroids

(Stimulating (Build up of
development of male muscle
sexual tissue)
characteristics)
 Anabolic
Androgenic
Steroids
•Known as training drugs
• Often taken during training and
stopped for several weeks before
competition to reduce risk of positive
testing
• They improve performance by:
• Increasing muscle size and strength
• Allowing athletes to train harder and
longer
• Increasing aggression and
competetiveness
 Anabolic
Androgenic
Steroids
• Side effects of abuse:
• Hypogonadism
• Gynecomastia
• Acne
• Alopecia
• Stunted growth (in teenagers)
• Infertility (in males and females)
• Agression
• Cardiovascular disease and death
 Beta-2-Agonists
• Although not anabolic steroids, they
have potent anabolic effects
• Increase muscle mass and thus
muscle strength
• Examples are salbutamol, &
clenbuterol
 Diuretics
• Examples; frusemide, triameterine…
• Abused to achieve rapid weight loss by
those competing in weight classes e.g.
weight lifting, boxing, wrestling…
• Also used to enhance excretion of
prohibited drugs before testing
• A serious adverse effect is profound
hypotension
 Peptide
Hormones
• Also called sports designer drugs
• Their popularity is because they are
indistinguishable from body’s
natural hormones and cannot be
detected by current methods
• Examples include:
• Human Chorionic Gonadotropin (HCG)
• Human Growth Hormone (HGH)
• Erythropoietin (EPO)
 HCG and HGH
Production of

endogenous
HCG testosterone

Anabolic effect
side effects:
• Acromegaly
• Gigantism
HGH
• Metab.
disturbances
 Erythropoietin
(EPO)
• EPO stimulates RBC production by
bone marrow
• It increases Hb levels thus
improving oxygenation of blood
• Abuse of EPO increases blood
viscosity and may lead to:
• Poor circulation
• Thrombotic lesions
• Myocardial infarction
 Natural
Supplements
• Nutritional aids to benefit performance
• Not prohibited in competitions
• Substances include:
• Carnitine
• Chromium picolinate (chronic renal failure)
• Creatine
• Purified amino acids (may → liver & kidney
damage)
• Hypervitaminosis is not uncommon
 Sodium
Bicarbonate
• Referred to as Soda doping
• Buffers lactic acid in blood from
fatigued muscle
• Popularly used by cyclers and sprinters
• Dose: upto 3mg/kg approx. 30 min
before exercise
 Sodium
Bicarbonate
• Side effects:
• Fluid retention
• Thirst
• Severe GIT discomfort
• Cardiac overload
• Alkalinization of urine → prolonged
half life of prohibited substances
(e.g. amphetamine &
pseudoephedrine) → enhanced
toxicity.
 Analysis

Analyzed for banned Locked away

substances
Analyzed if
sample A was
positive