Steroids & Stimulants

Topic updated on 04/22/15 9:01pm
Anabolic steroids
  • Introduction
    • cause increase in muscle strength 
    • increase aggressive behavior
    • increased erythropoiesis
    • side effects  
      • hypertension
      • liver tumors
      • increased LDL
      • decreased HDL 
      • hypercholesterolemia
  • Intake
    • either oral or injection routes possible
  • Evaluation
    • an abnormally low high-density lipoprotein level should alert the physician to the possibility of steroid use in an athlete. 
    • blood testing examines for testosterone to epitestosterone ratio of > 6:1
  • Physical exam
    • increased body weight
    • testicular atrophy
    • irreversible deepening of female voice
    • alopecia (irreversible)
    • reduction in gonadotropic and sex hormones (estrogen and testosterone)
      • can lead to decreased bone mineral density
      • oligospermia or azoospermia
    • growth retardation
    • gynecomastia
  • Type of steroids
    • Human Growth hormone (HGH)
      • the most abundant substance produced by the pituitary gland.  Growth hormone has a direct anabolic effect by accelerating the incorporation of amino acids into proteins.  It is becoming an increasingly popular anabolic steroid substitute; 
      • similar effects from insulin-like growth factor (IGF-1)
      • increased muscle size but not strength
      • Side effects:
        • myopathic muscles development
        • carpal tunnel syndrome
        • insulin resistance
    • Androstenedione
      • an androgen produced by the adrenal glands and gonads
      • acts as a potent anabolic steroid and is converted in the liver directly to testosterone with a resultant increase in levels after administration.
    • DHEA
      • is a naturally occurring hormone made by the adrenal cortex.
      • it is converted to androstenedione, which in turn is converted to testosterone.  
      • the beneficial and adverse effects of DHEA can be correlated directly with those of testosterone.
    • Erythropoietin (EPO)
      • stimulates hemoglobin production and increases O2 carrying capacity
      • side effects
        • increased blood viscosity which can lead to stroke or myocardial infarctions
    • Somatotropin
      • a growth hormone that causes hypertrophy of type 1 muscles and atrophy of type 2 muscle
Catabolic Hormones
  • Glucagon
    • has a catabolic effect on skeletal muscle 
  • Creatine
    • Introduction
      • derived from glycine, arginine, and methionine
      • a muscle and power building supplement (not an anabolic steroid)
      • mechanism is that creatinine is converted to phosphocreatine, which acts as a source of ATP for muscle
        • studies have shown although it can increase work in anaerobic trials, it cannot increase peak force
      • widely used in conjunction with off-season weight lifting programs
    • Outcomes
      • studies show mixed results with regard to enhanced sports performance
    • Risks
      • pulls water from blood vessels into cells, creating a theoretical risk of dehydration
    • Reports of
      • cramps
      • increased muscle injury
      • renal insufficiency (rare)
  • Includes
    • caffeine
      • doses of 2 to 3 mg/kg have been shown to improve performance
      • works by reducing fatigue and increasing alertness
      • previously banned by the International Olympic Committee (IOC)
        • now allowed up to 12 micrograms per milileter of urine
    • ephedra
    • ephedrine
    • "ma huang"
      • often included in energy drink
    • amphetamines 
  • Risks include
    • dehydration
    • impaired heat management
    • high blood pressure
    • nervous system impairment



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Qbank (7 Questions)

(SBQ07.19) Which of the following is a side-effect from anabolic steroid use? Topic Review Topic

1. Renal failure with secondary hyperpararthyroidism
2. Decrease in low density lipoprotein
3. Decreased blood pressure
4. Decrease in fat
5. Decrease in high density lipoprotein

(SBQ07.45) A 17-year-old wrestler is noted to demonstrate increased aggression and hostility toward others at school. These are the most common behavioral side effects of what performance enhancing drug? Topic Review Topic

1. Furosemide
2. Erythropoietin
3. Stanozolol
4. a-Ketoglutarate
5. Propranolol

(OBQ08.62) An athlete asks about performance enhancing substances. Which of the following side effects is more common with creatine than with testosterone? Topic Review Topic

1. Muscle cramping
2. Hair loss
3. Testicle atrophy
4. Acne
5. Impotence

(OBQ07.238) At present, there is no widely accepted urine test to detect the use of which of the following performance-enhancing drugs? Topic Review Topic

1. Ephedrine
2. Dihydroepiandosterone
3. Androstenedione
4. Human growth hormone
5. Tetrahydrogestrinone

(OBQ07.268) A weightlifter informs you that he has been using methandrostenolone for performance enhancement. You advise him of the potential side effects. Which of the following has not been linked to the use of this product? Topic Review Topic

1. Decreased sperm count
2. Hypertension
3. Altered lipid profiles
4. Acne
5. Decreased vision

(OBQ05.215) What effect does glucagon have on skeletal muscle? Topic Review Topic

1. Anabolic
2. Catabolic
3. No effect
4. Nootropic
5. Ergogenic

(OBQ05.248) A 32-year-old professional cyclist suffered a myocardial infarction 6 months ago secondary to long term anabolic steroid use. Which of the following options describes the mechanism by which steroids most likely caused this patient's heart disease? Topic Review Topic

1. Increased plasma levels of high density lipoproteins
2. Decreased systolic and diastolic blood pressure
3. Increased plasma levels of low density lipoproteins
4. Alteration of myocardial conduction patterns
5. Direct endothelial damage to coronary arteries



Length: 15:00 (minutes:seconds) Title: Anabolic Steroids in Sports Medicine Focu...
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