Pharm And Doping

Question 1

First-line pharmacologic agent for osteoarthritis?

Answer 1

Acetaminophen. Max dose 3g/day. [Procedures]

Question 2

Why is aspirin less commonly recommended in athletes?

Answer 2

Narrow therapeutic/toxic window. [Procedures]

Question 3

Mechanism of NSAIDs?

Answer 3

Inhibit COX → ↓ prostaglandins. [Procedures]

Question 4

Major side effects of COX-1 inhibitors?

Answer 4

GI bleeding, renal effects. [Procedures]

Question 5

Cardiac risk with NSAIDs?

Answer 5

COX-2 selective may ↑ CV risk. [Procedures]

Question 6

Opioid use in sports?

Answer 6

Acute trauma/fractures, not recommended pre-performance. [Procedures]

Question 7

Corticosteroid injection rest rule?

Answer 7

48-hour rest after articular/epidural injection. [Procedures]

Question 8

Which corticosteroid routes are banned by WADA?

Answer 8

Oral, rectal, IV. [Procedures]

Question 9

Fluoroquinolone risks?

Answer 9

QT prolongation, tendon rupture (esp. w/ steroids, >50y). [Sports Injuries/Management]

Question 10

First-line drug for type II DM?

Answer 10

Metformin (biguanide). [Preventive Medicine]

Question 11

Metformin mechanism?

Answer 11

↓ hepatic glucose production, ↑ muscle uptake, ↓ insulin resistance. [Preventive Medicine]

Question 12

Contraindication for metformin?

Answer 12

Creatinine >1.4 (renal impairment). [Preventive Medicine]

Question 13

Sulfonylureas MOA?

Answer 13

↑ insulin secretion from pancreas. [Preventive Medicine]

Question 14

Sulfonylurea drawbacks?

Answer 14

Weight gain, hypoglycemia, sulfa allergy, teratogenic. [Preventive Medicine]

Question 15

Why are diuretics/beta-blockers avoided in athletes?

Answer 15

Dehydration, ↓ aerobic capacity, banned by WADA. [Preventive Medicine]

Question 16

Preferred antihypertensives in athletes?

Answer 16

ACEi, ARBs, CCBs. [Preventive Medicine]

Question 17

ACE inhibitor contraindications?

Answer 17

Pregnancy, renal artery stenosis. [Preventive Medicine]

Question 18

ACE inhibitor common side effect?

Answer 18

Cough. [Preventive Medicine]

Question 19

Best CCB for athletes?

Answer 19

Amlodipine. [Preventive Medicine]

Question 20

ARB mechanism?

Answer 20

Block angiotensin II → vasodilation. [Preventive Medicine]

Question 21

Rescue asthma med?

Answer 21

Albuterol (SABA). TUE needed if frequent/high dose. [Preventive Medicine]

Question 22

First-line maintenance asthma med?

Answer 22

Inhaled corticosteroids. [Preventive Medicine]

Question 23

Other maintenance asthma meds?

Answer 23

Leukotriene inhibitors (montelukast), cromolyn. [Preventive Medicine]

Question 24

Nasal corticosteroids in allergic rhinitis/EIA?

Answer 24

Flonase, Nasonex. [Preventive Medicine]

Question 25

Mechanism of viscosupplementation?

Answer 25

Hyaluronic acid for lubrication/shock absorption. [Procedures]

Question 26

Source of Synvisc/Hyalgan?

Answer 26

Rooster combs. [Procedures]

Question 27

Euflexxa derived from?

Answer 27

Bacterial fermentation. [Procedures]

Question 28

AAOS stance on viscosupplementation?

Answer 28

Recommends against for knee OA. [Procedures]

Question 29

AMSSM stance on viscosupplementation?

Answer 29

Supports use for pain/function improvement. [Procedures]

Question 30

When did IOC start drug testing?

Answer 30

1967. [Role of Team Physician]

Question 31

When was WADA created?

Answer 31

1999, after 1998 Tour de France. HQ Montreal. [Role of Team Physician]

Question 32

WADA vision?

Answer 32

Drug-free sports environment. [Role of Team Physician]

Question 33

WADA Prohibited List categories?

Answer 33

Always prohibited, in-competition only, sport-specific. [Role of Team Physician]

Question 34

Always prohibited substances?

Answer 34

Anabolic agents, hormones, beta-2 agonists (some), diuretics, masking agents. [Role of Team Physician]

Question 35

Prohibited in-competition?

Answer 35

Stimulants, narcotics, cannabinoids, glucocorticoids. [Role of Team Physician]

Question 36

Prohibited in certain sports?

Answer 36

Alcohol, beta-blockers. [Role of Team Physician]

Question 37

Prohibited methods?

Answer 37

Blood doping, EPO, IV manipulation, gene doping. [Role of Team Physician]

Question 38

Prohibited stimulants examples?

Answer 38

Amphetamines, pseudoephedrine, modafinil. [Role of Team Physician]

Question 39

Opioids banned except?

Answer 39

Codeine. [Role of Team Physician]

Question 40

Cannabis status?

Answer 40

Prohibited in-competition. [Role of Team Physician]

Question 41

Athlete responsibility in NCAA drug testing?

Answer 41

They must know rules; supplement contamination risk. [Role of Team Physician]

Question 42

NCAA drug policy?

Answer 42

Each school sets policy, NCAA must approve. [Role of Team Physician]

Question 43

Therapeutic exemption system?

Answer 43

ADAMS online database, must file ≥21d before competition. [Role of Team Physician]