Monday, April 8, 2013

Sports Pharmacy

While in pharmacy school, I was fortunate enough to have an athletic scholarship. Balancing the responsibility to workout before and after class four days per week, compete on the weekend and study in-between was certainly challenging. But being a pharmacy student-athlete, I found, to be more interesting and though provoking by marrying the two together: pharmacy and athletics - drug/supplements and performance.

Most athletes competing at a high level are focused on improving themselves, through both training and nutrition. Extending beyond that, dietary supplements, performance-aids and performance enhancing drugs are also utilized. However, the use of any supplement is often highly regulated by amateur and professional athletic organizations. ‘Banned substance lists’ restrict the use of selected performance enhancing substances. Determining whether a given supplement contains one or more ‘banned substances’ is difficult due to poor product labeling as well as unfamiliarity of the pharmaceutical or chemical
names used in both the banned substance list as well as product labeling.

Any pharmacist with a pulse would look at this and see an area of opportunity to help inform athletes about nutritional supplement product information as well as supporting literature. Further, utilizing expertise in pharmacology and pharmacokinetics, pharmacists can be integral members of anti-doping teams: screening athletes for banned substances or their metabolites. While researching these opportunities as a student, I came across Dr. Ambrose doing just that. Dr. Ambrose, of UCSF, has been involved in drug screening with the NCAA and the Olympic Games (Atlanta, Sydney, and Beijing).

A recent article published by Dr. Ambrose and a group of PharmD candidates, reviewed the evidence surrounding common pre-workout supplements. In a field of relatively scant data, this review concisely reports what evidence exists supporting the use of common supplements (RedBull, creatine, etc). In a nutshell, most ‘legal’ supplements do not significantly improve athletic performance. Importantly, harmful effects of high doses of caffeine were highlighted and the association of the combination of exercise related tachycardia potentially leading to adverse cardiovascular effects.

The data presented does leave more to be desired. There are many obstacles imposed by the NCAA and individual athletic departments in conducting studies (even surveys) when student-athletes are used as the subjects. These are just obstacles, not impenetrable barriers.

Lastly, as a pharmacist, I’ve been involved with Sports Medicine
professionals to help them understand the banned substance lists as well as deciphering supplement labeling. It’s certainly not as glamorous as pharmacokinetic analyses of the metabolites and excretion of banned substances to enhance detection of banned substances in urine or saliva, but it’s a start.

Eudy AE, Gordon LL, Hockaday BC, Lee DA, Lee V, Luu D, Martinez CA,
Ambrose PJ. American Journal of Health-System Pharmacy;70(7): 577-588