Learning objectives
On completion of the course, the student must know the basic principles of general Pharmacology (methods of administration, absorption, elimination and metabolism), general concepts of pharmacokinetics and pharmacodynamics, drugs of the autonomous central nervous system, stimulants and inhibitors of the central nervous system, anti-inflammatory drugs, local anesthetics, analgesics and the most important drugs of abuse. The student must know the history of doping, the list of prohibited substances, national and international regulations, current legislation, applicable sanctions, control procedures, short- and long-term desirable and undesirable effects of the drugs used, analytical techniques used in anti-doping controls, characteristics of biological sampling and the variables that influence the reliability of results. Must also be able to set the phenomenon of doping and related issues in the current social-cultural context.
Prerequisites
Recommended requirements: basic knowledge of Physiology
Course unit content
<br />General pharmacology. Methods of administration; transport processes; metabolism; distribution; elimination.<br />Pharmacokinetics: compartment model; time-dose relationship.<br />Pharmacodynamics: receptor; competition and rivalry.<br />Use of drugs in medicine: fight against disease. From drugs with low efficacy to increasingly powerful drugs. Evolution of the concept of health: from the absence of disease to well-being. Change in relationship: from patient to client. Responsibility of the physician (intentional and negligent) and healthcare employee in the use of drugs.<br />Drugs and sport Drug prescription in the area of sports. Integration, supplementation, treatment, doping. Syndromes of success. Fair play and sports ethics.<br />Doping: history; definitions; aspects of the problem; psychological motivations of the problem; scandals; risk. Health care tutelage of sports activity: regulative and legislated issues on a national and regional level.<br />Antidoping: laws and general procedures of controls; regulations of CONI and individual sports federations; the role of the FMSI (Italian sports medical federations); sanctions, limits of current regulations. <br />Laboratory medicine applied to doping. Exams: definition; typology; method of request. Properties and characteristics of biological samples. Pre-analysis and analysis variables that influence the reliability of results. Operative strategies in lab studies of prohibited substances or methods: 1) direct identification; 2) recognition of induced metabolic or biochemical alterations.<br />I Substances and methods consistently prohibited (during and outside competition)<br /><br />S1) Anabolic steroids:<br /> 1 – Androgenous anabolic steroids (a - Exogenous b - Endogenous)<br /> 2 – Other anabolic steroids (clenbuterol, zeranol, zilpaterol)<br />Anabolism and catabolism<br /><br />S2) Hormones and correlated substances:<br />erythropoietin, somatotrope, IGF-1, MGFs, LH, hCG, insulin, ACTH, tetracosactide.<br />Hematochemical studies: basic and complementary parameters and any supplementary dosages. Endocrine control of energy substrates.<br /><br />S3) Beta2 agonists (salbutamol, salmeterol, formoterol, terbutaline, clenbuterol, ractopamine, cimaterol.....)<br /><br />S4) Agents with anti-estrogenic activity:<br /> 1 – Aromatase inhibitors<br /> 2 – Estrogen receptor selective modulators<br /> 3 – Other anti-estrogenic substances.<br /><br />S5) Diuretics and other masking agents:<br /> epitestosterone, probenecid, plasma expanders.....<br /><br />M1) Increase in oxygen transport:<br /> a – hematic doping; b – artificial transporters.<br />Concepts in hemorheology.<br /><br />M2) Chemical or physical manipulation <br />masking agents, catheterisation, sample tampering, endovenous infusion.<br /><br />M3) Genetic doping<br /><br />II – Substances and methods prohibited in competition<br /><br />All in section one plus:<br /><br />S6) Stimulants:<br />mimetic sympathetic amine, amphetamine, cocaine.<br />Pharmacology of the autonomous nervous system: neurotrasmittiters; neuromodulators; cholinergic system; adrenergic system. Overview of specialised pharmacology on respiratory apparatus drugs.<br /><br />S7) Narcotics: <br />heroine, morphine, methadone, barbiturates..... .<br />Overview of specialised pharmacology of the central nervous system and drug abuse.<br /><br />S8) Cannabinoids<br /><br />S9) Glucocorticoids<br /><br />III – Substances prohibited in certain sports<br /><br />P! 1) Alcohol <br /><br />P2) Beta blockers<br /><br />P3) Diuretics<br />Overview of specialised pharmacology in cardiovascular, anti-inflammatory drugs and related alcohol problems.<br /><br />IV – Specific substances<br /><br /> 1) Ephedrine, methylephedrine, methylamphetamine. 2) Cannabinoids. 3) All<br /> beta 2 agonist inhalants, except clenbuterol. 4) Probenecid. 5) All<br /> glucocorticosteroids. 6) All beta-blockers. 7) Alcohol.<br /><br />Fight against doping: Intervention strategies.
Bibliography
D.R. Mottram: Farmaci e Sport. Casa Editrice Ambrosiana<br /><br />L. Spandrio: Biochimica Clinica. Ed. Sorbona, Milano.<br /><br />D. De Wied, W. De Jong e A. Witter: Farmacol ogia Generale. Ed. Piccin<br /><br />R.A. Harvey e P.C. Champe: Farmacologia. Ed. Zanichelli<br />
