Treatment with inhaled β2-agonists or oral leukotriene antagonist do not enhance physical performance in nonasthmatic highly trained athletes exposed to −15°C

Use of prescription drugs in athletes

Although athletes are young and generally healthy, they use a variety of non-doping classified medicines to treat injuries, cure illnesses and obtain a competitive edge. Athletes and sports medicine physicians try to optimize the treatment of symptoms related to extreme training during an elite athlete's active career. According to several studies, the use of antiasthmatic medication is more frequent among elite athletes than in the general population. The type of training and the kind of sport influence the prevalence of asthma. Asthma is most common among those competing in endurance events, such as cycling, swimming, cross-country skiing and long-distance running. Recent studies show that athletes use also NSAIDs and oral antibacterials more commonly than age-matched controls, especially athletes competing in speed and power sports. Inappropriately high doses and concomitant use of several different NSAIDs has been observed. All medicines have adverse effects that may have deleterious effects on elite athletes' performance. Thus, any unnecessary medication use should be minimized in elite athletes. Inhaled beta(2)-agonists may cause tachycardia and muscle tremor, which are especially harmful in events requiring accuracy and a steady hand. In experimental animal models of acute injury, especially selective cyclo-oxygenase-2 inhibitors have been shown to be detrimental to tissue-level repair. They have been shown to impair mechanical strength return following acute injury to bone, ligament and tendon. This may have clinical implications for future injury susceptibility. However, it should be noted that the current animal studies have limited translation to the clinical setting. Adverse effects related to the CNS and gastrointestinal adverse reactions are commonly reported in connection with NSAID use also in elite athletes. In addition to the potential for adverse effects, recent studies have shown that NSAID use may negatively regulate muscle growth by inhibiting protein synthesis. Physicians and pharmacists taking care of athletes' medication need to be aware of the medicines that an athlete is taking and how those medicines interact with performance, exercise, environment and other medicines. Sport associations should repeatedly monitor not only the use of banned substances, but also the trends of use of legal medicines in athletes. Not only physicians and pharmacists, but also athletes and coaches should be better educated with respect to potential benefits and risks, and how each agent may affect an athlete's performance. The attitudes and beliefs leading to ample use of legal medicines in athletes is an interesting area of future research.

Doping test reveals high concentrations of salbutamol in a Swiss track and field athlete

Beta-2 agonists are on the list of prohibited substances in sport. Salbutamol by inhalation is permitted to treat allergic asthma, and/or exercise-induced asthma or exercise-induced bronchoconstriction. If the level of salbutamol in urine exceeds 1000 ng/mL, the result is considered as a doping violation with an anabolic steroid. We report a case of a track and field athlete who tested well above this limit during a competition. He had a valid therapeutic use exemption for the use of salbutamol by inhalation and he claimed that he never used salbutamol orally. Further studies under controlled application by inhalation showed that this limit was exceeded. We propose that sanctioning bodies in sport should consider this possibility before taking into account a two-year ban for the use of an anabolic steroid.

Acute formoterol administration has no ergogenic effect in nonasthmatic athletes

PURPOSE

To determine the effect of formoterol (formoterol fumarate dihydrate) on the aerobic and anaerobic capacities of highly trained athletes.

METHODS

10 male athletes (age = 26.2 +/- 0.9, VO(2max) = 65.6 +/- 2.4 mL x kg(-1) x min(-1)) with minimal bronchial reactivity to aerosols (i.e., negative methacholine challenge test) completed three identical exercise sessions differing only by the medication administered. Formoterol (F) a long-acting beta(2)-agonist, presently not approved for international competition by the I.O.C. Medical committee, was compared with salbutamol (S), an accepted bronchodilator, and a placebo (P). Formoterol (12 microg), salbutamol (400 microg), or placebo was administered by a Turbuhaler, 10 min before exercise testing in a double-blind, randomized, three-way crossover design. Testing sessions included a Wingate anaerobic test followed 15 min later by an incremental cycle ergometer test to exhaustion.

RESULTS

There were no significant differences between the groups in VO(2max) (F = 66.5 +/- 2.7; S = 67.8 +/- 2.5; P = 67.5 +/- 2.1 mL x kg(-1) x min(-1)) or Wingate peak power (F = 885 +/- 40; S = 877 +/- 40; P = 885 +/- 44 W) values. During the maximal aerobic test, no differences were observed in maximum minute ventilation, respiratory exchange ratio, heart rate, or work between the three experimental conditions. Also, there were no differences in the Wingate anaerobic test variables, total work, or fatigue index.

CONCLUSION

Formoterol, administered in one aerosolized therapeutic dose, does not have an ergogenic effect in elite athletes without asthma.