This study presents a novel physio-pharmacological framework for assessing the potential performance-enhancing effects of substances and methods included in the 2022 World Anti-Doping Agency (WADA) Prohibited List across 160 Olympic sport disciplines. An expert panel evaluated 31 consolidated pharmacological categories for their capacity to enhance performance across six core physiological athletic demands. Using a calibrated scoring function and bilinear interpolation, we mapped these effects to each sport's dominant physiological profile. Findings confirmed the well-known ergogenic effects of anabolic agents and erythropoietins for power and endurance-based sports, respectively, including the general ergolytic effects of narcotics and cannabinoids. Moreover, the methodology can be used to evaluate any new sport or substance given their respective physiological demands. The study underscores the need for targeted anti-doping strategies, suggesting that risk assessment and test distribution planning should be aligned with sport-specific physiological demands and the relative performance advantages conferred by different doping strategies. This summary of the current physiological knowledge and pharmacological knowledge has the potential to enhance detection efficiency, optimize resource allocation, and refine prohibited substance screening in elite sport.

Background: A high proportion of bodybuilders use supplements to improve performance, with some turning to prohibited substances and methods. The attitudes of bodybuilders towards performance enhancement may be gauged through surveys such as the Performance Enhancement Attitude Scales (PEAS). Educational interventions are recommended as part of anti-doping measures. The objective of this project was to assess the impact of a pharmacy-led intervention using an antidoping educational flyer and the performance enhancement attitude scale to measure the attitude of bodybuilders in the United Arab Emirates (UAE). Methods: The PEAS eight-item short form questionnaire was administered to male bodybuilders in the UAE. The PEAS was conducted before and after administration of an educational flyer concerning the problems associated with supplement use among bodybuilders. The Wilcoxon Signed-Rank and Kruskal Wallis tests were used for data analysis. Results: A total of 218 bodybuilders, who reported taking dietary supplements, filled out the survey both pre and post viewing the antidoping educational flyer. A difference was observed between the full-time professional bodybuilders, students, and part-time bodybuilders with other primary occupations (p-value <0.05). In addition, PEAS score decreased among the study population for all eight PEAS items (p-value <0.05). Conclusions: The pharmacy-led intervention using an antidoping educational flyer and sensitization by PEAS achieved more favorable scores, suggesting a significant shift of opinion toward avoiding use of performance enhancing substances among the bodybuilder study population. More research is required on sustaining the attitude and demonstrating the impact on doping behavior.

Background A high proportion of bodybuilders use supplements to improve performance, with some turning to prohibited substances and methods. The attitudes of bodybuilders towards performance enhancement may be gauged through surveys such as the Performance Enhancement Attitude Scales (PEAS). Educational interventions are recommended as part of anti-doping measures. The objective of this project was to assess the impact of a pharmacy-led intervention using an antidoping educational flyer and the performance enhancement attitude scale to measure the attitude of bodybuilders in the United Arab Emirates (UAE). Methods The PEAS eight-item short form questionnaire was administered to male bodybuilders in the UAE. The PEAS was conducted before and after administration of an educational flyer concerning the problems associated with supplement use among bodybuilders. The Wilcoxon Signed-Rank and Kruskal Wallis tests were used for data analysis. Results A total of 218 bodybuilders, who reported taking dietary supplements, filled out the survey both pre and post viewing the antidoping educational flyer. A difference was observed between the full-time professional bodybuilders, students, and part-time bodybuilders with other primary occupations (p-value <0.05). In addition, PEAS score decreased among the study population for all eight PEAS items (p-value <0.05). Conclusions The pharmacy-led intervention using an antidoping educational flyer and sensitization by PEAS achieved more favorable scores, suggesting a significant shift of opinion toward avoiding use of performance enhancing substances among the bodybuilder study population. More research is required on sustaining the attitude and demonstrating the impact on doping behavior.

A number of peptide hormones that occur naturally in the body are included on the WADA Prohibited List. Erythropoietin (EPO) increases red blood cell counts, thereby enhancing oxygen supply to muscles and enhancing endurance and recovery. Use of EPO can be detected in the laboratory either directly or through biomarkers as part of the Athlete Biological Passport. Chorionic gonadotrophin (CG) and luteinising hormone (LH) have the potential to increase endogenous testosterone levels and counteract side-effects experienced by long-term anabolic androgenic steroid use. Growth hormone (GH) has a number of significant biological effects, including the increase in muscle mass and strength. The effects of GH are mediated through insulin-like growth factor-1 (IGF-1), which is used to detect GH use through the Biomarker Test. Localised growth factors that are central to increased muscle size, function and repair appear in the muscle-building supplements market. The misuse of peptide hormones and growth factors by athletes poses a serious risk to health.

Beta-2 agonists are first-line drugs in the treatment of asthma and other obstructive airways diseases because of their bronchodilatory activity. Exercise-induced asthma and bronchoconstriction are conditions prevalent in elite athletes involved in high volumes of training. Increased prevalence is evident among those engaged in endurance sports and in winter sports and swimming particularly. The performance-enhancing potential for beta-2 agonists is dependent on the dose and route of administration of the drugs. This is reflected in WADA’s regulations concerning the prohibition of this class of drugs, including the criteria for Therapeutic Use Exemption.

Drugs are potent substances that are used widely in modern society. The mechanisms by which drugs are taken and interact within the body are complex. All drugs produce side-effects whose severity largely depends on dose and frequency of use. There are many reasons why athletes may take drugs, including social use, therapeutic use for the treatment of medical conditions, nutritional supplementation, and the use of prohibited drugs for performance enhancement. The factors that may influence athletes to take prohibited drugs are complex and vary from athlete to athlete and from sport to sport. Drugs that appear on the World Anti-Doping Agency (WADA) Prohibited List are used to illustrate the issues concerning drug use in sport that are discussed within this chapter.

Diuretics act on the kidneys to increase urine flow. Diuretics may be misused by athletes to mask the use of other prohibited substances but may also be taken to temporarily reduce weight in sports where weight categories apply. A number of non-diuretic drugs, such as probenecid, desmopressin and plasma volume expanders, may also be used to mask prohibited drug use. According to the World Anti-Doping Agency (WADA) annual laboratory statistics, diuretics are one of the classes of prohibited substances most frequently used by athletes. Diuretics have many clinical therapeutic uses; however, strict criteria apply with regard to applications by athletes for Therapeutic Use Exemption applications for diuretics.

The International Olympic Committee has recently launched the IOC Certificate in Drugs inSport. This review outlines the current need and learning objectives of the course, which has been developed for healthcare professionals and other athlete support personnel who require specialist knowledge and understanding on the use of drugs in sport.1 The postgraduate-level 6-month online course aims to protect the health of the athlete by ensuring medicines and supplements are used in a safe and effective way. It primarily focuses on the medical aspects of drug use in sport with emphasis on the role of healthcare professionals in the prevention of doping. Healthcare professionals are often the first people consulted by athletes on issues relating to drug use, from both clinical and antidoping perspectives. Athletes may require advice on the drug treatment for acute or chronic medical conditions, the pharmacological management of sport injuries, the use of dietary or ergogenic supplements, or the status of treatment according to the WADA List of Prohibited Substances and Methods.2 The World Anti-Doping Code recognises that healthcare professionals should play a significant …

BACKGROUND AND PURPOSE:The use and misuse of drugs in sport is becoming increasingly important globally, and the role of pharmacists is evolving in this regard. This paper describes the design and implementation of an elective course "Drugs in Sport" in an undergraduate pharmacy curriculum.EDUCATIONAL ACTIVITY AND SETTING:The elective course was designed to introduce BSc pharmacy students to an evidence-based approach to safe, effective, and legal use of drugs in sport. The course covered why athletes take drugs, evolution of doping in sport, the international regulations regarding doping and anti-doping in sport including the World Anti-doping Agency Prohibited List, as well as testing and monitoring for drug use in sport. It also included the role of athlete support personnel (ASP) in preventing the use of prohibited substances by athletes. A web-based survey was conducted at the end of the course to assess the students' perspectives of the course.FINDINGS:Students provided an evaluation of the course in terms of its content, methods of delivery, and assessment. Overall, the students demonstrated competence. They gained insight into international and national regulations regarding doping and anti-doping in sport and the potential role of pharmacists as ASP in providing support and advice for athletes and the public.SUMMARY:Designing and implementing an evidence-based course on the use of drugs in sport customized for pharmacy students was achieved successfully. Such courses could provide an opportunity to advance the scope of pharmacy practice and possibly provide a new career path for future pharmacists.

In recent years, pharmacy practice has undergone a significant evolution toward patient-centered care. These changes have occurred primarily as a result of demographic changes in population as well as political and economic forces modulating the healthcare systems in many countries. Pharmacy education has undoubtedly made a significant contribution to practice advancement. For the future pharmacy education, globally, needs to develop the educational outcomes, professional competencies, curricular content and processes that are required to prepare competent graduates to assume an integrated and accountable role in the healthcare system by having defined responsibilities for direct patient care. This will result in the development of effective patient care practitioners with appropriate skills, knowledge, and competencies to provide optimal pharmaceutical care and to advance health outcomes. This chapter is primarily intended to provide insight into the evolution of patient and pharmaceutical care as a new model of practice and how pharmacy education contributes in these transformations around the world.

BACKGROUND:The aim of this study was to evaluate the current knowledge and perceptions of pharmacists in Qatar with regard to the use of drugs in sport and to explore their views on the introduction of education and training in the area of sports pharmacy.METHODS:A cross-sectional survey was conducted targeting both hospital and community pharmacists in Qatar. A questionnaire consisting of three domains pertaining to participants' knowledge, perceived role of healthcare professionals, and attitudes towards educational needs on the use of drugs in sports was developed and validated. The online survey link and paper-based questionnaires were distributed to the target population. Data analyses were performed using IBM SPSS Statistics. Descriptive and inferential statistics were utilized for the analyses, where P<0.05 indicates statistical significance.RESULTS:A total of 300 pharmacists responded to the survey. Respondents had a limited awareness of doping and anti-doping and achieved an average knowledge score of 53.2% regarding the prohibited status of drugs that may be used by athletes, particularly with respect to over-the-counter medicines and supplements. The majority (81.7%) of the pharmacists expressed an interest in receiving education and training on sports pharmacy.CONCLUSIONS:Specialized training programs are warranted to ensure that pharmacists have the knowledge and skills required to provide athletes with accurate information about anti-doping issues and the safe and effective use of medicines in sport. The development of these programs should be supported by national pharmacy policy makers and designed in collaboration with anti-doping agencies and sports pharmacy experts and educators.

Objective. To assess pharmacy students’ knowledge and perceptions of doping and anti-doping in sports and to explore the curricular needs for undergraduate pharmacy in the field of sports pharmacy. Methods. A cross-sectional, descriptive, web-based survey of pharmacy students was conducted at Qatar University College of Pharmacy from March to May 2014. Data were analyzed using descriptive and inferential statistics. Results. Eighty respondents completed the online survey (80% response rate). Sixty percent were unaware of the World Anti-Doping Agency, and 85% were unaware of the International Pharmaceutical Federation’s statement on the pharmacist’s role in anti-doping. Students’ knowledge score regarding the prohibited status of drugs that may be used by athletes was around 50%. Fourth-year pharmacy students had significantly higher knowledge scores than the other groups of students. Respondents acknowledged the important role of health care professionals, including pharmacists, as advisors on the safe and effective use of drugs in sports. Ninety percent of the students supported the inclusion of sports pharmacy in the curriculum. Conclusion. Pharmacy students indicated a strong desire to play a role in doping prevention and ensure safe and rational use of drugs among athletes. They suggested requiring an education and training strategy for sports pharmacy in undergraduate pharmacy curricula.

Objectives This study aimed to evaluate the impact and legacy of pharmacists' professional development having worked as volunteers at the London 2012 Olympic and Paralympic Games.Methods Questionnaires were administered immediately following the Games and 1year after the Games. The first explored motivation for volunteering, training and support and reflection on personal experiences at the time of the Games. The second evaluated the personal and professional impact that working as a volunteer has had in the year following the Games.Results Immediately post-Games, 19 of the 22 (86.5%) respondents reported that they were able to use their pre-Games education and training effectively, particularly relating to antidoping regulations. One year after the Games, respondents reported that the experience had been influential on core aspects of their practice. Close collaboration with pharmacy colleagues, other healthcare professionals and Olympic and Paralympic team doctors was reported as a significant benefit of working at the Games.Conclusions Comprehensive education and training is beneficial in providing a safe and efficient medicine service for athletes and provides a lasting legacy in terms of improving the standard of care for athletes or people participating in sport.