ATC Pharmacology 5 — Questions and Answers
Question 1: An athlete is using creatine monohydrate supplementation. Under current WADA regulations, creatine is classified as:
- A prohibited substance in all sports
- A monitored substance requiring TUE
- A permitted supplement not on the prohibited list (Correct answer)
- A Schedule III controlled substance
Correct answer: A permitted supplement not on the prohibited list
Creatine is not prohibited by WADA and is freely available as a dietary supplement, though product contamination remains a concern.
Question 2: Which of the following is a primary concern when an athlete combines alcohol with acetaminophen (Tylenol)?
- Increased risk of gastrointestinal bleeding
- Potential for severe hepatotoxicity (Correct answer)
- Elevated risk of renal failure
- Additive CNS stimulation
Correct answer: Potential for severe hepatotoxicity
Both alcohol and acetaminophen are metabolized hepatically; combined use increases toxic metabolite production and risk of liver damage.
Question 3: Which pharmacokinetic process is primarily responsible for converting lipid-soluble drugs into more water-soluble metabolites for excretion?
- Absorption
- Distribution
- Metabolism (biotransformation) (Correct answer)
- Renal filtration
Correct answer: Metabolism (biotransformation)
Metabolism, primarily occurring in the liver, chemically transforms drugs into polar, water-soluble metabolites that can be excreted.
Question 4: An athlete taking erythropoietin (EPO) for performance enhancement is primarily seeking to improve which physiological parameter?
- Anaerobic power output
- Muscle protein synthesis
- Aerobic capacity by increasing red blood cell production (Correct answer)
- Neuromuscular coordination
Correct answer: Aerobic capacity by increasing red blood cell production
EPO stimulates red blood cell production, increasing oxygen-carrying capacity and improving VO2max in endurance events.
Question 5: Which of the following best describes the pharmacological concept of a 'therapeutic window'?
- The time period during which a drug is metabolized
- The range between a drug's minimum effective concentration and its minimum toxic concentration (Correct answer)
- The optimal time of day to administer a medication
- The window of opportunity to administer a drug after symptom onset
Correct answer: The range between a drug's minimum effective concentration and its minimum toxic concentration
The therapeutic window is the concentration range where a drug provides therapeutic effect without causing toxicity.
Question 6: A high school athlete's parent requests information about melatonin use for sleep disruption during travel. Which statement is most accurate regarding melatonin?
- Melatonin is a Schedule II controlled substance requiring a prescription
- Melatonin is prohibited by WADA during competition
- Melatonin is an endogenous hormone available OTC and not prohibited by WADA (Correct answer)
- Melatonin use in athletes under 18 is federally prohibited
Correct answer: Melatonin is an endogenous hormone available OTC and not prohibited by WADA
Melatonin is an endogenous hormone sold OTC in the U.S. and is not on WADA's prohibited list, making it permissible for athletes.
Question 7: An athlete reports chronic use of oral contraceptives. Which nutritional deficiency has the strongest evidence of association with long-term oral contraceptive use?
- Vitamin D
- Magnesium
- Riboflavin (B2) and Vitamin B6 (Correct answer)
- Vitamin A
Correct answer: Riboflavin (B2) and Vitamin B6
Long-term oral contraceptive use is associated with depletion of several B vitamins, particularly riboflavin and B6, due to altered metabolism.
ATC Pharmacology 5
An athlete is using creatine monohydrate supplementation.
Under current WADA regulations, creatine is classified as: