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

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Presentation on theme: "Sports and Exercise Medicine for the Pharmacist Eric J. Jarvi, Ph.D. Associate Dean and Professor Husson University School of Pharmacy."— Presentation transcript:

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

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

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

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

5 Physiological Effects of Exercise on Metabolic Rate Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)5  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 = ( calories/hour)

6 Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)6 Physiological Effects of Exercise on Blood Glucose

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

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

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

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

11 RX Soft Tissue Injuries11 “HS Sports-Related Injury Surveillance Study”

12 RX Soft Tissue Injuries12 “HS Sports-Related Injury Surveillance Study”

13 RX Soft Tissue Injuries13 “HS Sports-Related Injury Surveillance Study”

14 RX Soft Tissue Injuries14

15  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 Stages of Sports Injury Rehabilitation Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)15

16  R est, I ce, C ompression, E levation  M ovement, I ce, C ompression, E levation  Heat therapy  Strapping/bracing Non-drug Treatment of Injuries Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)16

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

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

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

20  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 Exercise Guidelines Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)20

21 CME Table Source: Excerpted from Tables 4.2 in Simon HB. The No Sweat Exercise Plan. Lose Weight, Get Healthy, and Live Longer. New York: McGraw-Hill; Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)21 ActivityPaceDurationCME Points Daily Activities CarpentryModerate30 minutes100 CleaningHeavy30 minutes150 Digging in yardModerate30 minutes190 Mowing lawnPushing hand mower30 minutes200 Pushing power mower30 minutes145 Raking lawnModerate30 minutes130 Stair climbingModerate, upstairs10 minutes100 Moderate, downstairs10 minutes30 Washing car by handModerate30 minutes100 Recreational Activities Aerobic danceModerate30 minutes200 BikingModerate30 minutes250 GolfingPulling clubs30 minutes145 Jogging12 minutes/mile30 minutes200 Rope jumpingModerate15 minutes200 SkiingDownhill or water30 minutes200 Cross-country30 minutes315 SwimmingModerate30 minutes230 TennisDoubles30 minutes160 Singles30 minutes200 WalkingModerate30 minutes125

22 Aerobic Exercise versus Resistance Exercise Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)22 AETRET Improves CV reserveIncreased muscle/bone mass/strength Increased skeletal muscle adaptationImproved psychological well being Decrease age-related accumulate of central body fat Decreased cognitive decline Trained older individuals sustain maximum exercise load with less CV stress and muscle fatigue Improved glycemic control and clearance of post-prandial lipids

23  History goes back to ancient Egypt  First laws governing doping in 1963  Prohibited substances  Prohibited methods Doping Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)23 Stimulants  2 agonists Narcotic analgesicsAnti-estrogenic agents CannabinoidsMasking agents Anabolic agentsGlucocorticosteroids Peptide hormones/analogs

24  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 ±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 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)24

25  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 ±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 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)25

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)26 Distribution of Mean values of Peak Force with 5 mg/kg BW Caffeine Distribution of Mean values of Average Force with 5 mg/kg BW Caffeine* Distribution of Mean values of Fatigue index with 5 mg/kg BW Caffeine* Distribution of Mean values of Time to Exhaustion with 5 mg/kg BW Caffeine Distribution of Mean values of Urinary Caffeine concentration following 5 mg/kg BW Caffeine ingestion

27  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 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): Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)27

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

29  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 Special Case #2 – Female Athlete (Female Athlete Triad) Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)29

30  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 Special Case #3 – Older Athlete Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)30

31  “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): References Sports Exercise and Medicine for the Pharmacist (Fall 2012 MPA)31


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