ATC Pharmacology 3 — Questions and Answers
Question 1: A collegiate athlete tests positive for a banned substance after using a contaminated dietary supplement. Under WADA rules, which principle governs this outcome?
- Presumption of innocence
- Strict liability (Correct answer)
- Preponderance of evidence
- Reasonable doubt
Correct answer: Strict liability
WADA's strict liability principle holds athletes responsible for any prohibited substance found in their body regardless of intent or source.
Question 2: Which NSAID is generally considered safest for athletes with mild renal impairment when short-term use is necessary?
- Ibuprofen
- Naproxen
- Ketorolac
- Celecoxib (Correct answer)
Correct answer: Celecoxib
Celecoxib (a COX-2 selective inhibitor) has less impact on renal prostaglandins at standard doses compared to non-selective NSAIDs.
Question 3: An athletic trainer notices an athlete is using a topical NSAID on a muscle contusion. What is a key advantage of topical over oral NSAID delivery?
- Faster systemic distribution
- Reduced gastrointestinal side effects (Correct answer)
- Higher peak plasma concentration
- Longer half-life in the bloodstream
Correct answer: Reduced gastrointestinal side effects
Topical NSAIDs achieve local therapeutic concentrations while significantly reducing systemic absorption and GI adverse effects.
Question 4: Which controlled substance schedule includes drugs with no currently accepted medical use in the United States?
- Schedule II
- Schedule III
- Schedule IV
- Schedule I (Correct answer)
Correct answer: Schedule I
Schedule I drugs, such as heroin and LSD, have no accepted medical use and a high potential for abuse under the Controlled Substances Act.
Question 5: An athlete on a selective serotonin reuptake inhibitor (SSRI) for depression begins a new training block. Which drug-exercise interaction concern should be monitored?
- Reduced cardiovascular response during exercise
- Increased risk of hyponatremia with prolonged endurance events (Correct answer)
- Elevated resting heart rate only
- Decreased perception of muscle fatigue
Correct answer: Increased risk of hyponatremia with prolonged endurance events
SSRIs can impair renal water excretion; combined with excessive fluid intake during prolonged exercise, this may cause exercise-associated hyponatremia.
Question 6: What is the primary mechanism by which opioid analgesics reduce pain?
- Inhibiting prostaglandin synthesis in peripheral tissues
- Blocking sodium channels in sensory neurons
- Binding to mu, kappa, and delta receptors in the CNS to inhibit pain signaling (Correct answer)
- Reducing inflammation by suppressing cytokine release
Correct answer: Binding to mu, kappa, and delta receptors in the CNS to inhibit pain signaling
Opioids exert analgesia primarily by binding to opioid receptors (especially mu) in the brain and spinal cord, inhibiting pain signal transmission.
Question 7: A football player is prescribed methylphenidate for ADHD. Which governing body must be notified for a Therapeutic Use Exemption (TUE) in NCAA-regulated competition?
- WADA
- USADA
- The athlete's team physician only
- The NCAA (Correct answer)
Correct answer: The NCAA
NCAA athletes must obtain a TUE through the NCAA or their institution's procedures for banned stimulants used therapeutically.
ATC Pharmacology 3
A collegiate athlete tests positive for a banned substance after using a contaminated dietary supplement.
Under WADA rules, which principle governs this outcome?