Drugs, Athletes, and Physical Performance

1. Vitamins and Athletes.- 1. Physiological Function.- 1.1. Water-Soluble Vitamins.- 1.2. Fat-Soluble Vitamins.- 2. Metabolism, Exercise, and Vitamins.- 3. Vitamin Supplementation and Enhanced Athletic Performance.- 4. Toxicity of Hypervitaminosis.- 4.1. Vitamin B Complex.- 4.2. Vitamin A.- 4.3. Vitamin D.- 5. Conclusion.- References.- 2. Fate of Anabolic Steroids in the Body.- 1. Introduction.- 2. Physiology of Androgenic Hormones.- 2.1. Structures and Names.- 2.2. Sites and Pathways of Androgen Production.- 2.3. Circulation of Androgens in the Blood.- 2.4. Regulation of Testosterone Synthesis and Secretion by the Testes.- 2.5. Actions and Mechanism of Action of Testosterone.- 2.6. Elimination of Androgens from the Body.- 3. Synthetic Anabolic Steroids.- 3.1. Uses of Anabolic Steroids.- 3.2. Contraindications for the Use of Synthetic Anabolic Steroids.- 3.3. Adverse Effects of Synthetic Anabolic Steroids.- 3.4. Structural Features of Synthetic Anabolic Steroids.- 4. Conclusions.- References.- 3. Nutrition, Fluid Balance, and Physical Performance.- 1. Introduction and History.- 1.1. Development of an Understanding of the Importance of Nutrition and Fluid Balance to Physical Performance.- 1.2. Present Practices in Athletics in Nutrition and Fluid Balance.- 2. Nutrition and Fluid Requirements during Physical Performance.- 2.1. Energy Requirements.- 2.2. Protein Requirements.- 2.3. Vitamin Requirements.- 2.4. Mineral and Trace Element Requirements.- 2.5. Fluid Balance, Thermoregulation, and Nutrition.- 3. Nutrition and Fluid Balance for Improved Physical Performance.- 3.1. Carbohydrate Loading.- 3.2. Fats.- 3.3. Proteins.- 3.4. Vitamins.- 3.5. Minerals and Trace Elements.- 3.6. Fluids.- 4. Conclusion.- References.- 4. Analgesics and Sports Medicine Charles.- 1. Introduction and a Discussion of Pain.- 2. Analgesic Drugs.- 2.1. Narcotic Analgesics.- 2.2. Non-narcotic Analgesics.- References.- 5. Calcium.- 1. Dietary Calcium Requirements.- 2. Relationship of Exercise to Calcium Needs.- 3. Changes in Calcium Requirements Secondary to Other Dietary Components.- 4. Changes in Calcium Requirements Secondary to Drugs Used by Athletes.- 5. Changes in Calcium Requirements Secondary to Major Physiological Changes.- 6. Dietary Sources of Calcium.- 7. Calcium Supplements.- 8. Toxicity of Excess Calcium Intake.- References.- 6. Muscle Relaxants.- 1. Neuroregulation of Skeletal Muscle.- 1.1. Alpha Motoneurons and Neuromuscular Transmission.- 1.2. Neuromuscular Junction.- 1.3. Spinal Reflexes.- 1.4. Regulation of Skeletal Muscle by the Brain.- 1.5. Skeletal Muscle Spasm.- 2. General Mechanisms of Muscle Relaxants.- 3. Drugs Acting at the Neuromuscular Junction.- 3.1. Competitive, Nondepolarizing Neuromuscular Blockers.- 3.2. Succinylcholine.- 3.3. Clinical Uses of the Neuromuscular Blocking Drugs.- 4. Centrally Acting Skeletal Muscle Relaxants.- 4.1. Diazepam.- 4.2. Chemical Congeners of Mephenesin.- 4.3. Chlorzoxazone.- 4.4. Cyclobenzaprine.- 4.5. Orphenadrine.- 4.6. Carisoprodol.- 4.7. Clinical Use of Centrally Acting Muscle Relaxants.- References.- 7. Anabolic and Androgenic Steroids.- 1. Physiology of the Androgens.- 2. Physiological Actions of the Androgens.- 3. Androgenic and Anabolic Steroid Drugs.- 4. Pharmacological Actions of the Androgens.- 4.1. Androgenic Steroid Drugs.- 4.2. Anabolic Steroid Drugs.- 4.3. Side Effects of Androgen Therapy.- Suggested Readings.- 8. Anti-inflammatory Agents.- 1. The Inflammatory Response.- 1.1. Vasodilatation and Hyperemia.- 1.2. Increased Permeability.- 1.3. Leukocyte Infiltration.- 1.4. Tissue Damage.- 2. Mediators of the Inflammatory Response.- 2.1. Mediators from Plasma.- 2.2. Mediators from Cells.- 3. Pharmacology of Anti-inflammatory Drugs.- 3.1. Carboxylic Acids.- 3.2. Oxicams.- 3.3. Pyrazoles.- Suggested Readings.- 9. Effect of Exercise on Fuel Utilization and Insulin Requirements.- 1. Fuel Utilization.- 2. Substrate Turnover Rates.- 3. Hormonal Control of Fuel Regulation during Exercise.- 3.1. Hormonal Control of Glucose Regulation.- 3.2. Hormonal Control of Free Fatty Acid Regulation.- 4. Adrenergic Control of Fuel Regulation During Exercise.- 4.1. Brief History.- 4.2. Adrenergic Control of Glucose Regulation.- 4.3. Adrenergic Control of Pancreatic Endocrine Secretions.- 4.4. Adrenergic Control of Free Fatty Acid Regulation.- 5. Mechanisms of Hormonal and Adrenergic Control of Fuel Regulation.- 6. Other Fuel Regulatory Factors.- 6.1. Cholinergic Control.- 6.2. Glucose Autoregulation.- 6.3. Dopamine.- 7. Clinical Considerations.- 7.1. Fuel Utilization in Diabetes.- 7.2. Exercise Effects on Insulin Requirements.- 7.3. Recommendations for Clinical Practice.- References.- 10. Drug Abuse in Athletes.- 1. Introduction.- 1.1. Why Do Athletes Abuse Drugs?.- 1.2. Definition of the Problem.- 1.3. Breadth of the Problem.- 1.4. Drug Research on Agents of Abuse.- 2. Blood Doping.- 3. Bicarbonate Ingestion.- 4. Growth Hormone.- 5. Anabolic Steroids.- 6. Anti-inflammatory agents.- 6.1. Steroid Anti-inflammatory Agents.- 6.2. Nonsteroidal Anti-inflammatory and Analgesic Agents.- 7. Psychomotor Stimulants.- 7.1. Amphetamines.- 7.2. Caffeine.- 7.3. Summary.- 8. Sympathomimetic Amines and Drugs Used to Treat Asthma.- 9. Recreational Drugs.- 9.1. Introduction.- 9.2. Alcohol.- 9.3. Marijuana.- 9.4. Cocaine.- 10. Conclusions.- References.- 11. Exercise and Immunity.- 1. Introduction.- 2. The Immune System.- 3. Exercise Effects on the Immune System.- 3.1. Acute Exercise-Induced Leukocytosis.- 3.2. Effects of Chronic Training on Leukocytes.- 3.3. Effects of Exercise on Humoral Immune Factors.- 4. Exercise-Induced Asthma.- 5. Conclusion.- References.- 12. Reproductive Consequences of Athletic Training in Women.- 1. Women and Exercise-Modern Trends.- 2. Background.- 2.1. Physiology of the Menstrual Cycle.- 2.2. Pathophysiology of the Menstrual Cycle.- 3. Hormonal Modulation in Exercise.- 3.1. Acute Response of Gonadotropins, Prolactin, and Steroids to Exercise.- 3.2. Long-Term Effects of Athletic Training on Hypothalamic-Pituitary-Gonadal Function.- 3.3. Risks of Athletic Amenorrhea.- 4. Exercise and Pregnancy.- 4.1. Limitation of Available Studies.- 4.2. Physiological Alterations of Normal Pregnancy.- 4.3. Effect of Pregnancy on Exercise Performance.- 4.4. Exercise Effects on the Fetus.- 4.5. Conclusions: Exercise and Pregnancy.- References.- 13. Human Growth Hormone.- 1. Introduction.- 2. Regulation of Growth Hormone Secretion.- 3. Chemistry.- 4. Physiological and Metabolic Effects of Growth Hormone.- 5. Growth Hormone Receptor and Intracellular Changes.- 6. The Interaction of Growth Hormone and Somatomedins.- 7. Clinical Features of Abnormal Growth Hormone Production.- 8. Pathology of Growth Hormone Production.- 8.1. Growth Hormone Deficiency.- 8.2. Growth Hormone Hypersecretion.- 9. Assessment of Growth Hormone Production.- 10. Growth Hormone Therapy.- 11. Summary.- References.- 14. CNS Stimulants and Athletic Performance.- 1. Introduction.- 1.1. General Pharmacology.- 1.2. Abuse, Tolerance, and Physical Dependence.- 2. The Magnitude of Drug Effects on Athletic Performance.- 3. Effects of Caffeine on Endurance and Physical Performance.- 3.1. Studies Showing Positive Effects with Caffeine.- 3.2. Studies Showing No Effect of Caffeine.- 3.3. Conclusions and Possible Mechanisms for the Effects of Caffeine on Endurance and Physical Performance.- 4. Effects of Amphetamines on Endurance and Physical Performance.- 4.1. Studies Showing Positive Effects with Amphetamines.- 4.2. Studies Showing No Effect of Amphetamines.- 4.3. Conclusions and Possible Mechanisms for the Effects of Amphetamines on Endurance and Physical Performance.- 5. Effects of Cocaine on Endurance and Physical Performance.- 6. Summary.- References.