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Sports and Exercise Medicine for the Pharmacist

Sports and Exercise Medicine for the Pharmacist. Eric J. Jarvi, Ph.D. Associate Dean and Professor Husson University School of Pharmacy. Physiological Effects of Exercise on Cardiac Output. Increased sympathetic stimulation Contraction of muscles around vessels

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Sports and Exercise Medicine for the Pharmacist

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  1. Sports and Exercise Medicine for the Pharmacist Eric J. Jarvi, Ph.D. Associate Dean and Professor Husson University School of Pharmacy

  2. Physiological Effects of Exercise on Cardiac Output Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) Increased sympathetic stimulation Contraction of muscles around vessels Dilation of resistant vessels in muscles

  3. Physiological Effects of Exercise on Muscle Blood Flow Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) Flow at rest versus during exercise Mechanisms for increased blood flow

  4. Physiological Effects of Exercise on Oxygen Demand Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) Oxygen uptake by pulmonary blood Regulation of respiration

  5. Physiological Effects of Exercise on Metabolic Rate Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) • Muscle 100 x more heat than at rest • In well trained athlete body heat can • ↑50 x for a few seconds • ↑ 20 x for few minutes • Metabolic rate ↑ 2000 x • Basal metabolic rate (70 kg): • Bed = 1650 calories • Eating = 1850 calories • Sitting = 2000 calories • Exercise = (170-100 calories/hour)

  6. Physiological Effects of Exercise on Blood Glucose http://www.elmhurst.edu/~chm/vchembook/604glycogenesis.html Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)

  7. Physiological Effects of Exercise on Hydration Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) Exercise ↑ body temperature as results of three factors: metabolic rate, environmental conditions, body temperature Net water = [liquid/food consumed + metabolism] – [respiratoryloss+ GIloss+ renalloss+ sweatloss] Hypohydration versus euhydration versus hyperhydration

  8. Sports Nutrition(ADA Position Paper “Nutrition and Athletic Performance”) Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) Carbohydrate recommendations Protein recommendations Fat recommendations Dehydration Goals (pre-exercise, during exercise, post-exercise)

  9. Sports Injuries Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) • By location • Lower extremities at greatest risk • Upper extremities – greatest risk not age but specific skill demands • Central body

  10. Sports Injuries Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) • By injury type • Overuse • Strains (1st degree, 2nd degree, 3rd degree) • Contusion/hematoma • Sprains • Fractures • Dislocations • Fractures • Concussions (grade 1, grade 2, grade 3)

  11. “HS Sports-Related Injury Surveillance Study” 2009-2010 RX561.05 - Soft Tissue Injuries

  12. “HS Sports-Related Injury Surveillance Study” 2009-2010 RX561.05 - Soft Tissue Injuries

  13. “HS Sports-Related Injury Surveillance Study” 2009-2010 RX561.05 - Soft Tissue Injuries

  14. http://www.iaaf.org/mm/document/imported/42032.pdf RX561.05 - Soft Tissue Injuries

  15. Stages of Sports Injury Rehabilitation Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) Stage 1 – acute inflammatory process lasting up to 72 hours Stage 2 – regeneration and repair lasting 48 hours to 6 weeks Stage 3 – remodeling phase lasting 3 weeks to 12 months

  16. Non-drug Treatment of Injuries Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) Rest, Ice, Compression, Elevation Movement , Ice, Compression, Elevation Heat therapy Strapping/bracing

  17. Drug Treatment of Injuries Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) NSAID Opiate analgesics Corticosteroid injections Local anesthetics

  18. Drug Treatment of Soft Tissue Injuries Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) Skeletal-muscle relaxants Topical rubifacients Capsicum Drugs for bruising

  19. CAMS Treatment of Soft Tissue Injuries Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) Abrasions/cuts Stress Blisters Bruises Soft tissue injuries Cramps Pain

  20. Exercise Guidelines Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) • Physical activity guidelines (2008) • Avoid inactivity • Some better than none • Any activity provides some benefit • Metabolic equivalent units (MET) • Cardiometabolic exercise (CME) - General health and gradual weight loss = 150 points/day or ~1000 points/week

  21. CME TableSource: Excerpted from Tables 4.2 in Simon HB. The No Sweat Exercise Plan. Lose Weight, Get Healthy, and Live Longer. New York: McGraw-Hill; 2006. Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)

  22. Aerobic Exercise versus Resistance Exercise Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)

  23. Doping Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) • History goes back to ancient Egypt • First laws governing doping in 1963 • Prohibited substances • Prohibited methods

  24. Performance Enhancement“Effects of caffeine ingestion on strength and endurance performance of normal young adults” Sharma Archna, Sandhu S Jaspal, Doping Journal (2012): 7(2) Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) • Caffeine is on the watch list of doping of International Olympic Committee (IOC) • Maximum permissible urinary concentration by World Anti-Doping Agency (WADA) is 12 µg/ml. • 31 (17 male and 14 female) healthy university students with sedentary lifestyle (mean weight 63.0±2.9 kg, height 166.80±9.84 and age 24±2.25) reporting caffeine intake of ≤200 mg/week participated in the study • the dosage of caffeine tested was 5 mg/kg BW

  25. Performance Enhancement“Effects of caffeine ingestion on strength and endurance performance of normal young adults” Sharma Archna, Sandhu S Jaspal, Doping Journal (2012): 7(2) Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) • Caffeine is on the watch list of doping of International Olympic Committee (IOC) • Maximum permissible urinary concentration by World Anti-Doping Agency (WADA) is 12 µg/ml. • 31 (17 male and 14 female) healthy university students with sedentary lifestyle (mean weight 63.0±2.9 kg, height 166.80±9.84 and age 24±2.25) reporting caffeine intake of ≤200 mg/week participated in the study • the dosage of caffeine tested was 5 mg/kg BW

  26. Performance Enhancement“Effects of caffeine ingestion on strength and endurance performance of normal young adults” Sharma Archna, Sandhu S Jaspal, Doping Journal (2012): 7(2) Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)

  27. Exercise Effects in Chronic Drug Use“Reduced Diabetic, Hypertensive and Cholesterol Medication Use With Walking” Paul. T. Williams, Medicine and Science in Sports Exercise (2008): 40(3): 433-443 Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) • Study: n = 40,795 walkers • The ant-idiabetic, antihypertensive and LDL cholesterol-lower medication use may be reduced by walking, function of • Walking distance • Longest walk • Walking intensity

  28. Special Case #1 – Adolescent Athlete Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) Injury types and patterns differ from adult because of skill level, conditioning and musculoskeletal differences Common causes of injury Chronic injuries

  29. Special Case #2 – Female Athlete(Female Athlete Triad) Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) • First described at the 1993 meeting of the American College of Sports Medicine (ACSM) • Components: eating disordered, menstrual disorder, and osteoporosis • Pathophysiology: • Reduced energy availability • Menstrual dysfunction • Impaired bone health • Endothelial dysfunction

  30. Special Case #3 – Older Athlete Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) Injury as barrier to exercise Age associated muscle atrophy and loss of strength Bone loss Connective tissue changes Intrinsic factors contributing to injury Extrinsic factors contributing to injury

  31. References Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA) “Sports and Exercise Medicine for Pharmacists” Steven B.Kayne, Pharmaceutical Press (2006) Simon HB. The No Sweat Exercise Plan. Lose Weight, Get Healthy, and Live Longer. New York: McGraw-Hill; (2006) “Effects of caffeine ingestion on strength and endurance performance of normal young adults” Sharma Archna, Sandhu S Jaspal, Doping Journal (2012): 7(2) “Reduced Diabetic, Hypertensive and Cholesterol Medication Use With Walking” Paul. T. Williams, Medicine and Science in Sports Exercise (2008): 40(3): 433-443

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