1. سُسُببْْححََااننََككََ ل عِ للْْممََ لَ ننََاا إ إِ للّّ م مَاا عَ عَللّّممْْتتََننََاا إ إِننّّككََ
(( أأََننتتََ االْلْعَعَللِِييممُُ االْلْححََكِكِييممُُ سسووررةة االلببققررةة (( 3322

2. Gad El-Mawla Abd El-Aziz
Professor of Physiology
Mansoura University
M.B., B.Ch. 1974 Mansoura University, Egypt.
M.Sc. (Physiology) 1980.
PhD. (Physiology) 1984.
Professor of Physiology (1994).
E-mail: elmawla@hotmail.com

3. DDDDooooppppiiiinnnngggg
Merlene Ottey
Jamaica Sprinter
CCaannaaddiiaann sspprriinntteerr BBeenn JJoohhnnssoonn

4. OOOOrrrriiiiggggiiiinnnn ooooffff tttthhhheeee wwwwoooorrrrdddd
 It is derived from the Dutch word "dop", a
beverage that Zulu soldiers used before
battles.
 The term is used at 20th century in
reference to illegal drugging of racehorses
 It is derived from "dop" an alcoholic drink
used as a stimulant in ceremonial dances
in Southern Africa.

5. HHHHiiiissssttttoooorrrryyyy
 Egyptian slaves fed elixirs (likely from khat
leaves) to relieve stress
 Greek athletes ate energy boosting
substances prior to activity
 A century ago, marathoners used
strychnine, and cyclists used caffeine,
cocaine, and even alcohol for an advantage.
The first reported death occurred in 1896
when an English cyclist died of an overdose

6. HHHHiiiissssttttoooorrrryyyy
1928 – IAAF (International Association of
Athletics Federations ) bans doping.
1935 - Isolation of testerone with
subsequent use of anabolic steroids
1966 – FIFA (football) UCI (cycling)
introduce drug testing.
1968 – drug testing first used in Olympic
Games
1974 – reliable test for anabolic steroids
introduced

7. HHHHiiiissssttttoooorrrryyyy
 1976 – IOC bans anabolic steroids
 1979 – testing for illegal drugs by IOC
begins
 1986 – IOC bans blood doping
 1999 – World Anti-Doping Agency
(WADA) founded
 2000 - first Olympics testing for EPO

8. PPrreevvaalleennccee
Over 1,000,000 Americans have used
anabolic steroids – 250,000 of them
adolescents

9. DDDDeeeeffffiiiinnnniiiittttiiiioooonnnn
 Doping means use of substances which
enhance performance. These substances
may be natural, synthetic, drugs or blood.
 The definition of doping established by
the International Olympic Committee
IOC is based on the prohibition of certain
types of pharmaceuticals.

10. What is a Performance-Enhancing
Substance (PES) ?
“...any substance taken in non-pharmacologic
doses specifically for the
purposes of improving sports performance,
- by increasing strength, power, speed, or
endurance
- or by altering body weight or body
composition.”

11. Why some aatthhlleetteess nneeeedd ddooppiinngg ??
 Some athletes do anything to win
 Belief that competitors take drugs
 Financial rewards
 Belief of enhanced performance
 An increase in strength and endurance
 Delay in the onset of fatigue

12. WWhhyy ssoommee aatthhlleetteess nneeeedd ddooppiinngg ??
 To enable the body to reach its utmost limits
 Weight control
 To avoid stress anxiety
 Pressure from coaches
 Increased ability to concentrate
 Decreased sensitivity to pain

13. WWoorrlldd AAnnttii DDooppiinngg AAggeennccyy ((WWAADDAA))
WWAADDAA wwaass eessttaabblliisshheedd iinn 11999999 ttoo
ccoooorrddiinnaattee tthhee ffiigghhtt aaggaaiinnsstt ddooppiinngg iinn
ssppoorrtt iinn aallll ffoorrmmss..

14. DDooppiinngg aanndd hheeaalltthh pprroobblleemmss
 Direct relationship between certain drugs
and certain health problems
 Several doping substances lead to drug
abuse and dependence.
 Some drugs have psychological effects
and lead to changes in the behavior.

15. DDooppiinngg aanndd hheeaalltthh pprroobblleemmss
 Caffeine intoxication can lead to
nervousness, overexcitement, insomnia, or
attacks of anxiety in certain persons.
 Cocaine or amphetamine intoxication can
cause hyperactivity, anxiety, anger, altered
judgment and violent behavior.
 Their chronic use can cause dulled
emotions, fatigue, sadness, social
withdrawal, mania and aggressiveness.

16. DDooppiinngg aanndd hheeaalltthh pprroobblleemmss
 Dangerous drug cocktails can be
made up of different drugs, or of similar
drugs with different names.
 Drug cocktails bring the dosage to
toxic levels e.g. amphetamines
combined with corticoids, cocaine,
caffeine or ephedrin; EPO combined
with aspirin; a combination of
androgens and GH.

17. TTyyppeess ooff DDooppiinngg

18. UUssee ooff TThheerraappeeuuttiicc ddrruuggss
BBeettaa--BBlloocckkeerrss
Advantages:
– Anti-tremor, anxiolytic effect
– Shooters, ski jumpers, archery
Disadvantages:
– Negative effect on endurance
– Depression
– Bronchospasm,
– Fatigue

19. UUssee ooff TThheerraappeeuuttiicc ddrruuggss
DDiiuurreettiiccss
Advantages:
– Rapid weight loss
– Boxing, wrestling, judo
Disadvantages:
– Negative impact on performance
– Dehydration, hypotension,
– muscle cramps,
– electrolyte imbalance

20. UUssee ooff TThheerraappeeuuttiicc ddrruuggss
NNaarrccoottiiccss ((OOppiiooiiddss))
Advantages:
•Pain killers
•Allow performance while injured
Disadvantages:
Increased risk of further injury, dependence,
drowsiness, mental clouding;
in high doses: respiratory depression, hypotension

21. PPeerrffoorrmmaannccee eennhhaanncciinngg ddrruuggss
CNS Stimulants
o Amphetamines
o Caffeine
Systemic Stimulants
o Adrenalin
o Ephedrine
o Pseudo-ephedrine
o Phenyl-propanolamine

22. PPeerrffoorrmmaannccee eennhhaanncciinngg ddrruuggss
Anabolic androgenic steroids
Beta 2 agonists
Peptide hormones: HCG
Corticotropins
Growth hormone
Blood doping

23. Anabolic Androgenic
Steroids (AAS)
 AAS are a class of steroid hormones
related to the hormone testosterone.
 Testosterone affects nearly every
system and tissue in the human body.

24. EEffffeeccttss ooff AAAASS
•The Androgenic effect
produces:
- Growth of the vocal cords and
deepens the voice
-  hair growth all over the body
- Development of sexual organs.
•The Anabolic effect produces:
 protein synthesis
 development of muscle mass
 physical strength
 growth of long bone.

25. AAddvvaannttaaggee ooff ((AAAASS))
 Aerobic capacity:  in red blood cell
production, which enhance endurance by
increasing 02 delivery.
 user’s ability to perform high-intensity
work.
AAS results in a positive effect on lean
body mass with exercise
Inhibition of the catabolic effect of
glucocorticoids

26. Systemic Effects of
AAS
 Secretion of GTH; FSH and LH
 Spermato-genesis; and decreased
testicular tissue.
Irregular menstruation in females
Hepatitis, Cholestasis and jaundice.
Steroid-induced tumors in the livers.
Hypertension,
Cardiac hypertrophy cardio-myopathy.

27. Systemic Effects of
AAS
 Excessive acne, alopecia, and
temporal hair recession.
 Psychiatric changes with
aggressive behavior, depression,
dependency, irritability, frequent
mood swings, and libido changes.
  immunoglobulin (Ig A, Ig M) .
 Changes in lipid profiles:  in
HDL and  total cholesterol

28. Systemic Effects of
AAS
  hematocrits and hypercoagula-bility
of blood.
 Premature closure of epiphysis.
 Irreversible masculinization in
women (hirsutism, deepening of the
voice, and clitoral enlargement).

29. SSiiddee eeffffeeccttss ooff AAAASS
 Hepatitis hepato-cellular carcinoma
 Cardio-myopathy
 Congestive heart failure
 Thrombosis of coronary arteries
 Cerebro-vascular accidents
 Pulmonary embolisms
 Brain tumors
 Wilms’ ( kidney) tumors
 Feminization, virilization,
 Premature closure of the epiphysial plates,

30. Why athletes ddoonn''tt ssttoopp AAAASS
 Withdrawal symptoms of AAS:
- depression
- low levels of energy
- headache
- Psychological disturbance
 When the athlete discontinues these drugs,
he may note a decrease in strength and size of
his muscles.
 Some athletes feel they cannot be
competitive in their sport without the help of
steroids.

31. GGrroowwtthh HHoorrmmoonnee
(1)  Protein and nucleic acid
synthesis in skeletal muscle.
(2)  lipolysis and overall  in body
fat.
(3)  healing after musculo-skeletal
injuries.
NB : Growth hormone is not detected by
present urine drug testing techniques.

32. Side Effects ooff GGrroowwtthh HH..
 Gigantism in pre-pubertal individuals.
 Acromegaly in adults
 Muscular weakness.
 Arthritis, osteoporosis.
 Impotence.
 Hyper-lipidemia.
 Diabetes.
 Cardio-myopathy.

33. BBBBlllloooooooodddd DDDDooooppppiiiinnnngggg
Blood doping is the infusion of blood into
an individual with a normal level of red
blood cells to induce polycythemia.

34. BBBBlllloooooooodddd DDDDooooppppiiiinnnngggg
 Administration of blood or related
blood products, including erythropoietin.
 The aim of Blood Doping is to increase
the oxygen-carrying capacity of the blood
which improves the Aerobic capacity of
the athletes.
  in VO2 max and HB concentrations .

35. Types and methods of
blood Doping
Autologous blood doping (own blood)
 Withdrawal of 900 ml blood 4 - 5 weeks
prior to competition
 RBCs are preserved via glycerol freezing
 Athletes train to allow HB to return to
normal
 Infusion of the (packed cells) one or two
days prior to competition

36. Types and methods of
blood Doping
Autologous
• Advantages
– No detection method
– Avoidance of transmitted diseases
– Avoidance of transfusion reactions
• Disadvantages
– Recovery from loss of blood
– Decrease in efficacy of training
– Dangers of improperly stored blood

37. Types and methods of
blood Doping
Homologous blood doping (blood
from another person)
• Advantages
– No decrease in performance during
donation period
• Disadvantages
– Reliable doping test
– Transmission of diseases
– Transfusion reactions

38. Use of Erythropoietin (rEPO)
in Blood doping
 Recombinant erythropoietin (rEPO)
is a genetically engineered substance
similar to erythropoietin.
 (rEPO) is used in treatment of
anemia of chronic end-stage renal
disease and other forms of anemia.
 Athletes use (rEPO) instead of blood
transfusion to  RBCs formation.

39. Role of Erythropoietin in RBCs
formation

40. Risks associated with
blood doping
o Risk of infection
o Dangers of improperly stored blood
o Transfusion reaction
o Circulatory overload
o Hyperkalemia because of hemolysis
o Arterial hypertension
o Headache
o Thrombosis

41. Risks aassssoocciiaatteedd wwiitthh rrEEPPOO
 Arterial hypertension
 Venous Thrombosis
 Headache and muscle pain
 A suspicious  in the number of deaths
 Polycythemia is aggravated by dehydra-tion
which  risk of thrombosis.
  ABP and polycythemia  risk of
stroke, myocardial infarction.

42. SSttiimmuullaannttss
These are agents which increase
organic activity through their effects
on CNS, PNS, skeletal muscle, and
smooth muscle.
They increase muscle contractility
and speed reaction time.

43. Stimulants are uusseedd bbyy aatthhlleetteess ffoorr::
Their effects in  muscle
contractility, delaying fatigue
and speeding reaction time
Their appetite-suppressing
effects to lose weight.

44. AAmmpphheettaammiinnee
 Potent sympathomimetic drug.
 It causes release of noradrenalin
and has a direct action on a and b
adrenergic receptors.
  motor activity,  alertness,
delay fatigue, enhance speed,
power, endurance, and
concentration

45. SSiiddee EEffffeeccttss ooff AAmmpphheettaammiinneess
11.. DDeeccrreeaassee ppeerrffoorrmmaannccee iinn aatthhlleetteess..
22.. AAnnxxiieettyy dduurriinngg tthheeiirr uussee..
33.. DDeeppeennddeennccee..
44.. DDeepprreessssiioonn ffoolllloowwiinngg tthheeiirr wwiitthhddrraawwaall..
55.. TTrreemmoorr,, hhyyppeerrtthheerrmmiiaa,, vvaassooccoonnssttrriiccttiioonn
66.. VVaarriiaabbllee ggaassttrrooiinntteessttiinnaall eeffffeeccttss,,
77.. CCaarrddiiaacc aarrrrhhyytthhmmiiaass,, aannggiinnaa,,
88.. SSuuddddeenn ddeeaatthh..
99.. AAggiittaattiioonn aanndd aaccuuttee ppssyycchhoossiiss ..
1100.. cceerreebbrraall hheemmoorrrrhhaaggee,,

46. CCaaffffeeiinnee
 It contains theophylline and theobromine.
 It stimulates CNS, producing decreased
fatigue and possibly improving
psychomotor coordination.
 It stimulates voluntary skeletal muscle
thereby increase performance in
endurance events.

47. CCaaffffeeiinnee
◘Caffeine promotes the release of free fatty
acids into the blood stream and thereby
preserves glycogen stores as a ready source
of energy.
◘ Shortened reaction time,
◘ improved concentration,
◘ Diuresis
◘ Glycogen sparing leading to delayed fatigue

48. CCaaffffeeiinnee
◘ Dose: 250—350 mg have been shown to
enhance performance in endurance
athletes.
◘ To achieve banned levels of caffeine in
the body, most athletes would need to
consume 5-6 cups of coffee within 2 hours
of competition.

49. AAddvveerrssee eeffffeeccttss ooff CCaaffffeeiinnee
Agitation, irritability , Tremors
Supra-ventricular tachycardia, cardiac damage,
Arrhythmias
Addiction
Caffeine acts as a moderate diuretic and may
accelerate dehydration.
Dyspepsia,
combination with other stimulants (e.g.
ephedrine) may be fatal

50. NNiiccoottiinnee
• Athletes use nicotine for:
- Its stimulant properties
- Mood- altering effects
- Mild appetite-suppressing effect
- ? Enhances performance.
- Provides calming sensation in somebody
and stimulating effect in others.

51. AAddvveerrssee eeffffeeccttss ooff NNiiccoottiinnee
Adverse effects
of tobacco use

52. Use of Human chorionic
gonadotropin (hCG)
(hCG) the hormone of pregnancy, given
intravenously or intramuscularly, has been
shown to increase both endogenous
testosterone and epitestosterone levels in
users,
It is used by athletes alone and in
combination with AAS to elevate
endogenous testosterone levels and to
minimize testicular atrophy.

53. Other stimulants commonly
used by athletes
Theophylline,
 Beta-agonists,
 Salbutamol,
 Ephedrine,
 Pseudoephedrine,
 Isoproterenol,
 Decongestants

54. EEnneerrggyy ddrriinnkkss
 Provid more energy than a typical drink.
 Contain large amounts of caffeine
 Contain stimulants
 Contain diuretic which lead to dehydration

55. EEnneerrggyy ddrriinnkkss
Side effects
 Seizures
 Health concerns
 Sudden Death
 Alcohol further
contributes to
problems.

56. CCeerrttaaiinn ffoooodd pprroodduuccttss
Certain amino acids have been shown to
increase levels of endogenous growth hormone in
athletes.
Some plant steroids such as yohimbine are
being used as anabolic agents, in the human body
they are converted into AAS.
Ginseng, a Chinese plant, its chemical structure
is similar to pseudo-ephredrine. Ginseng may
enhance performance.
Food supplements: Creatine, colostrum,
antioxidants, sodium bicarbonate, vitamins,
proteins, amino acids

57. TTeessttss ttoo ddeetteecctt ddooppiinngg
HCT and HB can suggest blood doping.
Compare the numbers of mature and
immature RBCs in circulation
Markers on RBCs.
EPO, is detected by gel electrophoresis.

58. SSaammppllee ccoolllleeccttiioonn
BBlloooodd
UUrriinnee

59. FFaammoouuss UUnnlluucckkyy AAtthhlleettee
CCaannaaddiiaann sspprriinntteerr BBeenn JJoohhnnssoonn
SSttrriippppeedd ooff hhiiss ggoolldd mmeeddaall IInn 11998888 -- SSeeoouull OOllyymmppiicc
LLiiffee bbaann aafftteerr sseeccoonndd ppoossiittiivvee tteesstt iinn 11999933

60. BBBBaaaannnnnnnneeeedddd ddddrrrruuuuggggssss
There are over 1000 on a list that is
constantly changing.
They can be injected, swallowed and
inhaled.
Food supplements have become a
popular method of administering
them.

61. DDOOPPIINNGG SSUUBBSSTTAANNCCEESS SSEEIIZZEEDD
AAmmpphheettaammiinnee ,, AAnnaaddrrooll ,, AAnnaappoolloonn ,, AAnnaasstteerroonn,,
AAnnddrriiooll,, BBoollddeennoonnee,, BBoollddoonnee,, CC2255??,, CCaaffffeeiinnee,,
CCaavveerrjjeett,, EEssiicclleennee,, CCiippiioonnaattoo,, CCiippiioonnaattoo GGoolldd
lliinnee,, CClleennbbuutteerroolloo,, CClloobbeennzzoorreexx ++ EEpphheeddrriinnee,,
CClloommiidd,, CCoonnffiiddooll,, DDeeccaa--dduurraabboolliinn 220000,, DDeeccaa--
dduurraabboolliinn 22000000,, DDeeccaa--dduurraabboolliinn OOrrggaannoonn,, DDeeccaa--
dduurraabboolliinn MMuullttiiddoossee,, DDeeppootteesstt,, DDhheeaa,, DDiiaannaabbooll,,
DDrroollbbaann

62. DDOOPPIINNGG SSUUBBSSTTAANNCCEESS SSEEIIZZEEDD
DDyynnaabboolloonn,, EEpphheeddrriinnee,, EEpphheeddrriinnee ++ CCaaffffeeiinnee,,
EEpphheeddrriinnee ++ CClloobbeennzzoorreexx ++ CCaaffffeeiinnee,,
EEppaarrggrriisseeoovviitt,, EEqquuiippooiissee,, EErriittrrooggeenn,,
EErryytthhrrooppooiieettiinn,, EEuuttiirrooxx,, FFiinnaajjeett,, GGaannaabbooll,, SSaaiizzeenn
GGeennoottrrooppiinn,, HHuummaattrrooppee,, GGlloobbuurreenn,, GGoonnaassii HHPP,,
HHaallootteessttiinn,, IIGGFF,, IInnssuulliinnaa,, KKrryyppttooccuurr,, LLaassiixx,,
MMaasstteerroonn,, MMeetthhaannddrroosstteennoolloonnee,, MMoodduurreettiicc,,
NNaannddrroolloonnee,,

63. DDOOPPIINNGG SSUUBBSSTTAANNCCEESS SSEEIIZZEEDD
Nandrolone Cipionato, NNaannddrroolloonnee DDeeccaannooaattee,,
NNaannddrroolloonnee DDeeccaannooaattee –– NNoorrmmaa,, NNaannddrroolloonnee
DDeeccaannooaattee 22000000,, NNaannddrroolloonnee DDeeccaannooaattee –– OOrrggaannoonn,,
NNaappoossiimm,, NNeeoottoonn,, NNoollvvaaddeexx,, NNoonnssttaassuuss
NNoorrtteessttoosstteerroonnee,, OOmmnnaaddrreenn,, OOxxaannddrroolloonnee,,
OOxxiimmeettaannddrroosstteennoolloonnee,, OOxxiimmeettoolloonnee,, PPaarraabboollaann
PPeerrccuuttaaccrriinnee,, PPlleeggiinnee,, PPrriimmoobboollaann,, PPrriimmoobboollaann
AAcceettaattee,, PPrriimmoobboollaann DDeeppoott,, PPrriimmoobboollaann SS,, PPrrooccaaiinnaa,,
PPrrooffaassii HHPP 550000,, PPrrooffaassii HHPP 11000000,, PPrrooffaassii HHPP 22550000,,

64. DDOOPPIINNGG SSUUBBSSTTAANNCCEESS SSEEIIZZEEDD
Profasi HP 5000, Progynon, PPrroovviirroonn,, RReessttaannddooll
RRWWRR DDrriivvee,, SSyynnaacchhtteenn,, SSppeeccttrriiooll,, SSppiirrooppeenntt,,
SSuussttaannoonn,, SSyynntthhooll,, TT33 TT44,, TTeesstteexx,, TTeessttoo,, TTeessttoo--
EEnnaanntt,, TTeessttoonn,, TTeessttoosstteerroonnee,, TTeessttoovviirroonn,, TTeessttoovviirroonn
DDeeppoott,, TTeessttoovviiss,, TThhiioommuuccaassee,, TTrriiaaccaannaa,, VViiaaggrraa,,
WWiinnssttrrooll,, WWiinnssttrrooll DDeeppoott,, WWiinnssttrrooll MMuullttiiddoossee