SUBSTITUTES APPENDIX A OF THE OMAC 1999 OLYMPIC MOVEMENT ANTI-DOPING CODE APPENDIX A PROHIBITED CLASSES OF SUBSTANCES AND PROHIBITED METHODS 1 January 2003 PROHIBITED CLASSES OF SUBSTANCES
A. STIMULANTS
a
Prohibited substances in class A.a include the following examples with both their L- and D-isomers amiphenazole, amphetamines, bromantan, caffeine*, carphedon, cocaine, ephedrines**, fencamfamin, mesocarb, pentetrazol, pipradrol, . and related substances.
* For caffeine the definition of a positive is a concentration in urine greater
** For ephedrine and methylephedrine, the definition of a positive is a
concentration in urine greater than 10 micrograms per millilitre. For cathine, the definition of a positive is a concentration in urine greater than 5 micrograms per millilitre. For phenylpropanolamine and pseudoephedrine, the definition of a positive is a concentration in urine greater than 25 micrograms per millilitre. NOTE: All imidazole preparations are acceptable for topical use. Vasoconstrictors may be administered with local anaesthetic agents. Topical preparations (e.g. nasal, ophthalmological, rectal) of adrenaline are permitted. Bupropion, synephrine and phenylephrine are permitted b
Prohibited substances in class A.b include the following examples with both their L- and D-isomers formoterol***, salbutamol***, salmeterol*** and terbutaline*** … and related substances
*** permitted by inhaler only to prevent and/or treat asthma and exercise-induced asthma. Written notification by a respiratory or team physician that the athlete has asthma and/or exercise-induced asthma is necessary to the relevant medical authority prior to competition. At the Olympics Games, athletes who request permission to inhale a permitted beta-2 agonist, will be assessed by an independent medical panel. B. NARCOTICS
Prohibited substances in class (B) include the following examples: buprenorphine, dextromoramide, diamorphine (heroin), methadone, morphine, pentazocine, pethidine,. and related substances. NOTE: codeine, dextromethorphan, dextropropoxyphene, dihydrocodeine, diphenoxylate, ethylmorphine, pholcodine, propoxyphene and tramadol are permitted. C. ANABOLIC AGENTS
Prohibited substances in class (C) include the following examples: 1. Anabolic androgenic steroids
a.
clostebol, fluoxymesterone, metandienone, metenolone, nandrolone, 19-norandrostenediol, 19-norandrostenedione, oxandrolone, stanozolol, . and related substances. b. androstenediol, androstenedione, dehydroepiandrosterone (DHEA), dihydrotestosterone, testosterone*, . and related substances.
Evidence obtained from metabolic profiles and/or isotopic ratio measurements
may be used to draw definitive conclusions.
* The presence of a testosterone (T) to epitestostrone (E) ratio greater than
six (6) to one (1) in the urine of a competitor constitutes an offence unless there is evidence that this ratio is due to a physiological or pathological condition, e.g. low epitestosterone excretion, androgen producing tumour, enzyme deficiencies.
In the case of T/E greater than 6, it is mandatory that the relevant medical
authority conducts an investigation before the sample is declared positive. A full report will be written and will include a review of previous tests, subsequent tests and any results of endocrine investigations. In the event that previous tests are not
available, the athlete should be tested unannounced at least once per month for three months. The results of these investigations should be included in the report. Failure to co-operate in the investigations will result in declaring the sample positive. 2. Other anabolic agents
clenbuterol, salbutamol *
* For salbutamol, a concentration in urine greater than 1000 nanograms per
millilitre of non-sulphated salbutamol constitutes a doping violation. D. DIURETICS
Prohibited substances in class (D) include the following examples: acetazolamide, bumetanide, chlortalidone, etacrynic acid, furosemide, hydrochlorothiazide, mannitol*, mersalyl, spironolactone, triamterene, . and related substances.
E. PEPTIDE HORMONES, MIMETICS AND ANALOGUES
Prohibited substances in class (E) include the following examples and their analogues and mimetics:
1. Chorionic Gonadotrophin (hCG) prohibited in males only; 2. Pituitary and synthetic gonadotrophins (LH) prohibited in males only; 3. Corticotrophins(ACTH, tetracosactide); 4. Growth hormone (hGH); 5. Insulin-like Growth Factor (IGF-1); and all the respective releasing factors
6. Erythropoietin (EPO); 7. Insulin*
*permitted only to treat athletes with certified insulin-dependent diabetes.
The term ‘insulin-dependent’ is used here to describe people with diabetes in whom insulin treatment is required, in the judgement of a suitably qualified physician. It will always be the case in Type 1 and sometimes in Type 2 diabetes mellitus. Written certification of insulin-dependent diabetes must be obtained from an endocrinologist or team physician.
The presence of an abnormal concentration of an endogenous hormone in
class (E) or its diagnostic marker(s) in the urine of a competitor constitutes an offence unless it has been proven to be due to a physiological or pathological condition. F. AGENTS WITH ANTI-OESTROGENIC ACTIVITY Aromatase inhibitors, clomiphene, cyclofenil, tamoxifen are prohibited only in males. G. MASKING AGENTS
Prohibited substances in class (G) include the following examples: diuretics, epitestosterone*, probenecid, plasma expanders (e.g . hydroxyethyl starch) Masking agents are prohibited. They are products that have the potential to impair the excretion of prohibited substances or to conceal their presence in urine or other samples used in doping control.
* The presence of a urinary concentration of epitestosterone greater than 200
ng/mL constitutes an anti-doping violation unless there is evidence that it is due to a physiological condition. Isotopic ratio mass spectrometry (IRMS) may be used to draw definitive conclusions. If the results of the IRMS are inconclusive, the relevant medical authority shall conduct an investigation before the sample is declared positive.
II. PROHIBITED
The following procedures are prohibited:
A. ENHANCEMENT OF OXYGEN TRANSFER
a. Blood doping. Blood doping is the administration of autologous,
homologous or heterologous blood or red blood cell products of any origin, other than for legitimate medical treatment.
b. The administration of products that enhance the uptake, transport or
delivery of oxygen, e.g. modified haemoglobin products including but not limited to bovine and cross-linked haemoglobins, microencapsulated haemoglobin products, perfluorochemicals, and RSR13.
B. PHARMACOLOGICAL, CHEMICAL AND PHYSICAL MANIPULATION
Pharmacological, chemical and physical manipulation is the use of substances and methods, including masking agents (ref I . G), which alter, attempt to alter or may reasonably be expected to alter the integrity and validity of specimens collected in doping controls. These include, without limitation, catheterisation, urine substitution and/or tampering, inhibition of renal excretionand alterations of testosterone and epitestosterone (ref I. G) measurements. C. GENE DOPING
Gene or cell doping is defined as the non-therapeutic use of genes, genetic elements and/or cells that have the capacity to enhance athletic performance. CLASSES OF PROHIBITED SUBSTANCES IN CERTAIN SPORTS
A. ALCOHOL
Where the rules of the governing body so provide, tests will be conducted for ethanol. B. CANNABINOIDS
Where the rules of the governing body so provide, tests will be conducted for cannabinoids (e.g. Marijuana, Hashish). At the Olympic Games, tests will be conducted for cannabinoids. A concentration in urine of 11-nor-delta 9- tetrahydrocannabinol-9-carboxylic acid (carboxy-THC) greater than 15 nanograms per millilitre constitutes doping. C. LOCAL ANAESTHETICS
Injectable local anaesthetics are permitted under the following conditions:
a. bupivacaine, lidocaine, mepivacaine, procaine, and related substances, can
be used but not cocaine. Vasoconstrictor agents may be used in conjunction with local anaesthetics;
b. only local or intra-articular injections may be administered; c. only when medically justified.
Where the rules of the governing body so provide, notification of administration may be necessary.
D. GLUCOCORTICOSTEROIDS The systemic use of glucocorticosteroids is prohibited when administered orally, rectally, or by intravenous or intramuscular injection. When medically necessary, local and intra-articular injections of glucocorticosteroids are permitted. Where the rules of the governing body so provide, notification of administration may be necessary E. BETA-BLOCKERS
Prohibited substances in class (E) include the following examples: acebutolol, alprenolol, atenolol, labetalol, metoprolol, nadolol, oxprenolol, propranolol, sotalol, . and related substances.
Where the rules of the governing body so provide, tests will be conducted for beta- blockers. IV. SUMMARY OF URINARY CONCENTRATIONS ABOVE WHICH A DOPING VIOLATION HAS OCCURED
phenylpropanolamine > 25 micrograms / millilitre
* referred to I.C.b and I.G.
SUBSTANCES AND METHODS PROHIBITED OUT-OF- COMPETITION
I.C. Anabolic I.D. Diuretics I.E.
Peptide Hormones, Mimetics and Analogues
I.G. Masking Agents II. Prohibited LIST OF EXAMPLES OF PROHIBITED SUBSTANCES AND PROHIBITED METHODS
CAUTION: This is not an exhaustive list of prohibited substances. Many substances that do not appear on this list are considered prohibited under the term "and related
substances". Athletes must ensure that any medicine, supplement, over-the-counter preparation or any other substance they use does not contain any Prohibited Substance. STIMULANTS:
clomiphene*, cyclofenil*, tamoxifen*.
* prohibited in males only BETA BLOCKERS
acebutolol, alprenolol, atenolol, betaxolol, bisoprolol, bunolol, carteolol, carvedilol, celiprolol, esmolol, labetalol, levobunolol, metipranolol, metoprolol, nadolol, oxprenolol, pindolol, propranolol, sotalol, timolol. Explanatory note concerning the IOC/WADA List of prohibited classes of substances and prohibited methods – 2003 I – Prohibited Classes of Substances
A - Stimulants
The stimulants class has been split into two groups a) and b) in order to better identify the beta-2 agonists Amineptine, bupropion, synephrine and phenylephrine have been removed from the list. C – Anabolic agents In the anabolic class, paragraph 2 has been rephrased as “other anabolic agents”. The anabolic nature of salbutamol above a concentration of 1000 ng/ml has been clearly expressed. E – Peptide hormones, mimetics and analogues
In the “Insulin” section, the note has been changed. F - Agents with an antioestrogenic activity
A class F, of substances bearing the name of “agents w ith an antioestrogenic activity” has been created. G – Masking agents
A separate class bearing the name of “masking agents” has been created. II – Prohibited methods In the “prohibited methods” section, different classes have been created relating t o: • The definition of blood doping
• The identification of oxygen carriers The pharmacological, chemical and physical manipulation section has been expanded. A class C, Gene Doping, has been created.
III - Classes of prohibited substances in certain sp orts
In the paragraph “Classes of prohibited substances in certain sports”, the expression “responsible authority ” has been changed to “governing body”. IV – Summary of urinary concentrations above which a doping violation
has occurred. In this paragraph, only the concentration >1000 ng/ml for salbutamol remains considered as anabolic. Thus, below 1000 ng/ml a therapeutic justification and/or a examination by a medical panel is necessary; while above 1000 ng/ml is considered as having an anabolic effect. V – Substances and methods prohibited out-of-competition Chapter V has been changed taking into account the modifications above. In the list of examples, some modifications have been made.
1. Stimulants
Amineptine, bupropion and phenylephrine have been removed. Clobenzorex, fenproporex, methylenedioxymethamphetamine and phenmetrazine have been added.
2. Anabolic agents
Bolasterone and norbolethone have been added.
3. Diuretics
4. Masking agents
Bromantan has been removed and hydroxy ethyl starch added.
5. Substances with an antioestrogenic activity
This class has been added; clomiphene, cyclofenil and tamoxifen included therein.
6 . Beta Blockers
Please note: the following material is copyrighted by Lark Lands. Permission for commercial reproduction is NOT granted. Please contact the author if you wish to use this material. ****************************************************************************** Nutrient Therapy for Neuropathy by Lark Lands Last revision: May 2005 There have been a number of studies that have shown
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