Table of Contents:
[
General /
Adrenergic /
Amphetamine
]
[
Ergogenic /
Hormones /
Steroids
]
[
Over the Counter /
Recreational / Related ]
ANALGESICS (PAINKILLERS)
NON-STEROIDAL ANTI-INFLAMMATORY DRUGS
What are some of the problems related
to misuse of over the counter drugs (OTC)
Student athletes who use or intend to use OTC drugs should verify
permission to use these drugs with the team athletic trainer
or team physician, because some OTC drugs contain stimulants
which may result in a positive urinalysis. The majority of the
side effects related to these OTC drugs are related to CNS -
resulting in headaches, nervousness, irritability, and insomnia,
agitation, confusion, paranoia, hypertension and arrhythmia
(Wagner, 1991).
What are narcotic analgesics?
The most common use of narcotic analgesics is to relieve pain.
Narcotic analgesics or painkillers are categorized as agonists,
mixed agonist antagonists, or partial agonists by their activity
at opioid receptors. Activation of opioid receptors by the natural
release of endorphins or administration of the activation of
opioid receptors by the natural release of endorphins.
Narcotic-related drugs Narcotic-related drugs
are either chemically similar to narcotics or are used to treat
narcotic withdrawal or over dose. For example, clonidine (Catapres)
is used to treat narcotic withdrawal and naloxone, which is
a narcotic antagonist, is used to treat narcotic overdose. Naloxone
attaches to the opioid receptors and prevents narcotic drugs
such as a morphine or heroin to have an effect. Dextromethorphan
is a synthetic drug used in cough medication. It is structure
is similar to codeine. The abuse of this drug can cause mild
hallucination and PCP like stimulation.
How are narcotic analgesics administered?
Narcotic analgesics can be administered orally, into the vein,
under the skin or into the muscle. The oral route is preferred
but usually is not adequate for severe pain. The subcutaneous
and intramuscular routes are effective for the short-term treatment
of severe pain.
What are some therapeutic uses of narcotic analgesics?
Narcotic analgesics are use to treat coughs and are effective
antitussive agents. For example Codeine is used in cough medication.
The drugs are also used to relieve diarrhea.
What are some adverse effects of narcotic analgesics
on athletic performance?
Athletes who use narcotic analgesics or painkillers can experience
feelings of euphoria or psychological stimulation, false feelings
of invincibility. Narcotic analgesics increase the pain threshold
and as a result an athlete may fail to recognize injury, and
suffer more serious injury. Athletes may also use painkilling
drugs to mask injury in order to continue to participate in
their sports. As a result athletes who use painkillers might
place themselves at greater risk for injury (Walder and Hainline,
1989).
What are the major adverse effects associated with narcotic
analgesics?
One of the most common side effects of the opioid narcotics
is constipation. Other side effects include drowsiness, mental
clouding, itching, inability to urinate, low blood pressure.
Narcotic analgesics produce physical and psychological dependence.
Most of these drugs have major side effects, including dose-related
respiratory depression, apnea circulatory depression, respiratory
arrest, coma, shock and cardiac arrest. Most frequent adverse
effects are lightheadedness, dizziness, sedation, nausea, vomiting,
What are examples of some narcotics?
Examples of narcotics include heroin, morphine, methadone, fentanyl,
hydromorphone, meperidine, codeine, pentazocine, and propoxyphene.
For more information on banned drugs visit
the NCAA web site.
What are nonsteroidal anti-inflammatory drugs (NSAIDS)?
Medications known as non-steroidal anti-inflammatory drugs (NSAIDs),
have analgesic (pain killing) and anti-inflammatory actions
and are used to alleviate problems associated with pain and
swelling of injuries. NSAIDS that have been used for the treatment
of sports injuries include diclofenac (Voltaren), ibuprofen
(Advil, Aleve,Motrin), ketoprofen (Orudis), naproxen (Anaprox),
etc. and compounds such as Indomethacin (Indocin) and sulindac
(Clinoril), Vioxyl, Celebrex.
What is the mechanism of action of NSAIDS?
NSAIDS have analgesic and antipyretic effects. The major mechanism
of action of NSAIDS is believed to be inhibition of cycloxygenase
activity and prostaglandin synthesis. Other mechanisms of action
include inhibition of lipoxygenase, leukotriene synthesis, lysomal
enzyme release, and neutrophil aggregation. These drugs may
also suppress the production of a rheumatoid factor. Although
most NSAIDS are used for their anti-inflammatory effects often
they are effective analgesics and useful for the relief of mild
to moderate pain. Student athletes should also realize that
these drugs do not necessarily act to prevent an underlying
problem that may result from disease or incorrect technique.
How are NSAIDS metabolized and eliminated from the body?
NSAIDS are rapidly and completely absorbed and are highly protein
bound. Elimination of NSAIDS is through hepatic (liver) biotransformation.
NSAIDS metabolites are excreted via the kidney.
What are some examples of the approved uses of NSAIDS?
Rheumatoid arthritis, osteoarthritis, ankylosing spondylitis,
mild to moderate pain, primary dysmenorrhea, juvenile rheumatoid
arthritis, tendinitis, bursitis, acute gout, fever, sunburn,
migraine, cluster headaches, menorrhagia, premenstrual syndrome,
csytoid macular edema.
What are the common side effects of NSAIDS?
Some student athletes who use NSAIDs may experience common gastrointestinal
side effects such as: nausea, vomiting, diarrhea, constipation,
abdominal distress, cramps and pain, dyspepsia, flatulence,
anorexia, stomatitis. Other adverse side effects include dizziness,
headache, vertigo, drowsiness, tremor, psychic disturbances,
mental confusion, congestive heart failure, hypotension, hypertension,
and renal, hematologic, dermatologic, and respiratory problems.
What are the symptoms of overdosing NSAIDS?
Sometimes users of NSAIDs may experience drowsiness, dizziness,
mental confusion, disorientation, lethargy, vomiting, numbness,
ringing in the ears, sweating, convulsions, coma, blurred vision,
seizures, diminished urinary flow, low blood pressure and kidney
failure.
Student athletes should be aware that treatment
with NSAIDs might effectively reduce pain, swelling and inflammation;
however, when painkillers are used to reduce pain the injury
may still is present. Therefore, it is important to proceed
with caution when exercising the injured area (that is now pain-free)
to prevent further damage.
