Physical Culture and Sport \ 3.Sports Medicine and Rehabilitation

Vershinin E.G.

Volgograd State Medical University, Russia

The risks associated with medication use in sport

Modern sport development is accompanied by a high level of competition at the national and international arenas and, correspondently, a sharp increase of scope and intensity of physical training, which supposes ultimate mobilization of physiological capacity of the body. Rehabilitation and somatic mobilization after physical training and physical activity in addition to particular quality development (according to sport specialization) is an essential component to train highly skilled sportsmen, including medical provision such as mineral-vitamin supplement on a regular basis (Medic V. A., St. George V.K., 2001; Polyaev B.A., Parshchikov N.V., 2005; Vershinin E.G., Voronkov A.V., 2012).

The risk of pharmacological correlation is mostly characterized by two factors: possibility of side effects and it’s pronounced. Detection and prevention of adverse effects in using active substances helps to avoid many medical errors in sport training practice. To evaluate drug adverse effects, it is essential to know the drug used and to take into account individual traits.

Mechanism of pharmacological action is primarily emphasized. Side effects of some medications are closely linked to the mechanism of their influence, which actually refers to predictable effects in their intake. If drug therapeutic and toxic concentrations in the blood are equal, so it may produce side effects most probably. In this case, special attention should be paid to systematic assessment of drug actions and early detection of adverse effects. Dosage increase of some medications drugs may result in elimination of drug concentration in the blood due to protein inefficiency to bind prescribed drugs. Sportsmen should be aware of over dosage signs. In many cases to measure a drug level in the blood from time to time is useful for dosage correlation.

The liver and kidneys are the most "over prescribed" internal organs in sportsmen. In the case of liver dysfunction, drug administration is dangerous, as metabolism and drug clearance are regulated by its proper functioning. Medicines effecting hepatic blood flow or altering metabolic activity of the liver, are able to change other drug’s effects, forming complex drug interactions. Such preparations as antacids inhibit other drugs absorption in the gastrointestinal tract. If they are scheduled in medical provision as a mean of treatment, their intake should be held off to minimize possible influence on drug absorption.

Life threating conditions are states when one of the drugs blocks side effect manifestations of others or doesn’t produce adverse clinical signs. Beta-blockers are able to suppress hunger, nervousness and other sympathetic-adrenal manifestations of hypoglycemia. The only early clinical sign is sweating. That's why beta-blockers are prohibited in sport - they can lead to fatal outcomes in sportsmen caused by hypoglycemia in competitions.

When new drugs are prescribed in addition to administered ones possibility of their interaction increases, targeting of this interaction is difficult to predict. Therefore it is very important to reduce the amount of drugs to a lower limit, thus it is necessary to evaluate not only the possibility of side effects, but also their pronounce, which can be described by the following parameters: probability of sharp deterioration in a health status, and a sudden death (most often associated with doping) difficulty in identifying and eliminating due to the times of their appearance.

The term pronounced side effects is closely related to the type of possible disturbances. For example, pulmonary embolism caused by a birth control medicine intake, especial on strenuous physical exertions in extreme conditions, occurring rare, should be paid much attention to as it can lead a young woman to fatal outcome.

To some extent, pronounce of side effects depends on difficulties of their detection and elimination. Medicines causing depression (e.g. dopegit, propranolol, reserpine) are particular dangerous as clinical depression may remain unrecognized of early stages. In order to avoid adverse effects, sportsmen should be warned of possible signs by a doctor.

Reversibility of adverse effects is determined by pronounced limitation by means of prompt medical disposal correlation. But if in case of medical correlation regular monitoring is not used some irreversible complications can occur. Doctor's ability to reveal side-effects, allows him to reduce its pronounce and moderate its effects. Thus, it is necessary to instruct sportsmen about possible side-effects.

Neglecting pronounced side effects may lead to many medical errors. Sound assessment of possibility and pronounce of potential side effects can greatly reduce predictable risks. Nowadays it is clear that nothing will make skilled sportsmen refuse using drugs which help them in chance their achievements (Robert C. Mack., 2001).

Thus, highly qualified physicians and trainers have to be trained to preserve sportsmen health and contribute to their high rewards in sport on the one hand, and reasonable medication intake on the other hand. Beside it, the issue to work out evidence-based strategies of medication use in sport raises, as social practice ethically and legally completed allow to minimize existing risks (ruling them out seems to be unsolvable problem).

Literature:

1. Vershinin E.G. Medication abuse in sport as an ethical problem / Vershinin E.G., Voronkov A.V. // Bioethics. - 2012.-T. 2, № 10. S. 19-21.

2. Robert C. Mack. Bodybuilding without steroids. M. Media Sport. 2001. - P.224.

3. Medic V.A. Health, environment and way of life of modern sportsmen/ Medic V.A., St. George V.K.// - Moscow: Medicine, 2001. - P.72-84.

4. Polyaev B.A. Medicine in Sport / Polyaev B.A., Parshchikov N.V. // Medicine and Sport. 2005. - № 1. - C.4-5.