Pharmacists Play a Unique Role in Creating Clean Sports

Pharmacists play a crucial role in providing accurate medication-related information to athletes to prevent the use of prohibited substances, manage medication therapy, and enhance athletic performance.^1,2 A strong knowledge of pharmacology and clinical pharmacotherapeutics is essential for sports pharmacists, enabling them to support athletes' overall health while ensuring compliance with anti-doping regulations.^3,4 The use of banned substances to enhance athletic performance is known as doping, but athletes often take supplements and herbal products to improve their performance, sometimes leading to unintentional doping and associated complications.⁴

Roles of Pharmacists in Sports

Pharmacists can collaborate with the World Anti-Doping Agency | Image credit: Gibster | stock.adobe.com

Doping Control

The use of performance-enhancing substances has existed since ancient times, with examples including herbal products like mushrooms, strychnine, and sesame seeds. To prevent drug misuse and minimize harmful effects, pharmacists can collaborate with the World Anti-Doping Agency (WADA), established in 2000, to understand ethical and non-ethical drug use in sports.^5,6

Several medications are banned by WADA, including amphetamines and their derivatives. Athletes with asthma require counseling regarding approved anti-asthmatic medications. Beta-2 agonists, for instance, are restricted due to their potential performance-enhancing effects. However, inhaled salbutamol (albuterol) and salmeterol are permitted for asthma symptom relief. The use of salbutamol should not exceed 1600 mcg per day, as stipulated by anti-doping regulations.⁶

Providing Pharmaceutical Care in Sports

Injuries and illnesses are common among athletes, necessitating medication for recovery. Pharmacists play a crucial role in identifying potential drug interactions and adverse effects and ensuring safe medication use based on their expertise in pharmacology and pharmacotherapy.⁷

A common interaction occurs between nonsteroidal anti-inflammatory drugs and anti-asthmatic medications, which can lead to severe adverse reactions in athletes.^8,9 Educating athletes on the risks of stimulants such as amphetamines, caffeine, and anabolic steroids is also vital, as these substances are commonly used as ergogenic aids but can have significant health risks.¹⁰

Implementation of Sports Pharmacy Programs

Sports pharmacy programs in universities have significantly benefited student-athletes by providing specialized health care services, medication monitoring, and education on safe drug use.¹¹ Advanced Pharmacy Practice Experiences in sports pharmacy, incorporating medicinal chemistry, have enhanced student pharmacists' ability to educate athletes and sports personnel about performance-enhancing drugs and supplements.¹² Implementing sports pharmacy programs fosters recognition of pharmacists' roles in sports medicine.

Optimizing Athlete Health and Performance Through an Interdisciplinary Approach

Clinical sports pharmacists play a critical role in assessing athletes' health by conducting laboratory tests, interpreting biomarkers, and collaborating with professionals such as nutritionists and athletic trainers. For example, b-blockers are commonly used to manage hypertension but can also be prescribed for anxiety.⁶ Athletes with anxiety may be on b-blockers, which require careful monitoring due to potential adverse effects. Abrupt discontinuation of b-blockers can lead to rebound hypertension, a risk that pharmacists can help mitigate through appropriate counseling and management.⁶

Challenges Faced by Pharmacists in Promoting Clean Sports

Pharmacists often lack extensive training in anti-doping regulations, limiting their ability to provide tailored support for athletes. This highlights the need for specialized education to equip pharmacists with the necessary expertise. Additionally, pharmacists' contributions to sports medicine are often underrecognized in many countries, diminishing their potential impact in promoting clean sports.^1,13

Conclusion

Enhanced education and training programs specifically designed for sports pharmacists are crucial for addressing challenges in sports medicine. Establishing clear guidelines will ensure uniform and effective practices across the field. By bridging these gaps, pharmacists can play a pivotal role in promoting clean sports, safeguarding athletes' health, ensuring fair competition, and upholding the integrity of sports. This strategy not only enhances pharmacists' expertise but also strengthens trust among athletes, coaches, and sports organizations. The ultimate goal is to develop an informed, proactive pharmaceutical practice that supports both athlete well-being and ethical sportsmanship.

REFERENCES

1. Greenbaum DH, McLachlan AJ, Roubin RH, Chaar BB. Pharmacists supporting athletes: a scoping review exploring the knowledge, role and responsibilities of pharmacists in preventing the unintentional use of prohibited substances by athletes. Int J Pharm Pract. 2022;30(2):108-115. doi:10.1093/ijpp/riac010

2. Kasashi K, Suzuki S, Sato A, Kawaguchi-Suzuki M. Clinical pharmacy services at the Tokyo Olympic and Paralympic Games and the sports pharmacist training program. J Am Col Clin Pharm. 2023;6(2). doi:10.1002/jac5.1869

3. Kasashi K. Specialist pharmacist training from the viewpoint of sports pharmacology. Yakugaku Zasshi. 2012;132(12):1325-1328. doi:10.1248/yakushi.12-00230-1

4. Choudhary A, Mehta R. Pharmacy vs doping: educating for a cleaner sport. Med Res Chron. 2024;11(4). doi:10.26838/MEDRECH.2022.11.4.721

5. Yesalis CE, Bahrke MS. History of doping in sport. 2003.

6. Ciocca M, Stafford H, Laney R. The athlete’s pharmacy. Clin Sports Med. 2011;30(3):629-639. doi:10.1016/j.csm.2011.03.003

7. Bomfim JHGG. Pharmaceutical care in sports. Pharmacy (Basel). 2020;8(4):218. doi:10.3390/pharmacy8040218

8. Alaranta A, Alaranta H, Helenius I. Use of prescription drugs in athletes. Sports Med. 2008;38(6):449-463. doi:10.2165/00007256-200838060-00002

9. Feucht CL, Patel DR. Analgesics and anti-inflammatory medications in sports: use and abuse. Pediatr Clin North Am. 2010;57(3):751-774. doi:10.1016/j.pcl.2010.02.004

10. Wagner JC. Enhancement of athletic performance with drugs. An overview. Sports Med. 1991;12(4):250-265. doi:10.2165/00007256-199112040-00004

11. Price KO, Huff PS, Isetts BJ, Goldwire MA. University-based sports pharmacy program. Am J Health Syst Pharm. 1995;52(3):302-309. doi:10.1093/ajhp/52.3.302

12. DellaVecchia MJ, Marrero RJ, James JL, Vanscoy TD, Lendoiro JE. Rebooting a sports pharmacy advanced pharmacy practice experience: utilizing medicinal chemistry as a foundational approach to get pharmacists back in the game. Curr Pharm Teach Learn. 2020;12(8):981-1003. doi:10.1016/j.cptl.2020.04.009

13. Kawaguchi-Suzuki M, Anderson A, Suzuki S. Reconsidering sports pharmacists and anti-doping education as the world celebrates the Olympic and Paralympic Games. Am J Pharm Educ. 2021;85(7):8695. doi:10.5688/ajpe8695