IHSA Pharmacology & Medication Management 2 — Questions and Answers
Question 1: An athlete is prescribed a beta-2 agonist for exercise-induced bronchoconstriction. Which form requires a Therapeutic Use Exemption (TUE) in WADA-governed sports?
- Inhaled salbutamol up to 1600 mcg/24h
- Oral salbutamol (Correct answer)
- Inhaled formoterol up to 54 mcg/24h
- Inhaled budesonide
Correct answer: Oral salbutamol
Oral beta-2 agonists are prohibited under WADA rules and require a TUE, while specified inhaled forms within dose limits are permitted.
Question 2: A certified coach notices an athlete taking an OTC supplement that lists 'proprietary blend' without individual ingredient amounts. What is the primary concern?
- Supplements with proprietary blends are always banned
- Hidden amounts may include prohibited substances at uncertain doses (Correct answer)
- Proprietary blends are more effective than labeled blends
- The supplement cannot be absorbed properly
Correct answer: Hidden amounts may include prohibited substances at uncertain doses
Proprietary blends can mask doses of stimulants or other prohibited substances, making contamination risk assessment impossible.
Question 3: Which medication class is most associated with masking agents in anti-doping contexts because it increases urinary output and can dilute drug metabolites?
- NSAIDs
- Diuretics (Correct answer)
- Antihistamines
- Corticosteroids
Correct answer: Diuretics
Diuretics are classified as masking agents under WADA because they can dilute urine and reduce detectable concentrations of prohibited substances.
Question 4: An athlete with a known penicillin allergy is given amoxicillin by a team physician. As a coach, your immediate responsibility is to:
- Document the incident and move on
- Ensure the athlete takes the medication as prescribed
- Alert medical personnel immediately and do not administer the drug (Correct answer)
- Have the athlete take an antihistamine first
Correct answer: Alert medical personnel immediately and do not administer the drug
Administering a known allergen can cause anaphylaxis; coaches must immediately alert qualified medical staff and withhold the medication.
Question 5: The term 'half-life' in pharmacology refers to:
- The time for a drug to reach maximum plasma concentration
- The time required for half the drug dose to be eliminated from the body (Correct answer)
- Half the recommended therapeutic dose
- The duration of the drug's peak effect
Correct answer: The time required for half the drug dose to be eliminated from the body
Half-life is the time needed for the plasma concentration of a drug to decrease by 50%, guiding dosing frequency.
Question 6: An athlete is prescribed methylprednisolone (an oral corticosteroid) for a severe allergic reaction during a competition period. Which anti-doping action is required?
- No action needed; corticosteroids are always permitted
- A TUE must be obtained before or retroactively as permitted (Correct answer)
- The athlete must withdraw from competition
- The prescription must be reported to USADA only after competition
Correct answer: A TUE must be obtained before or retroactively as permitted
Oral, intravenous, and intramuscular corticosteroids are prohibited in-competition and require a TUE, which can sometimes be retroactive in emergencies.
Question 7: Which principle should guide a coach when an athlete self-reports taking a new herbal supplement: advise them to stop immediately, continue without concern, research the ingredients for potential prohibited substances, or report it only if performance improves?
- Advise them to stop immediately without discussion
- Continue without concern since herbal supplements are natural
- Research the ingredients for potential prohibited substances before continuing (Correct answer)
- Report it only if performance noticeably improves
Correct answer: Research the ingredients for potential prohibited substances before continuing
Coaches should help athletes verify supplement ingredients against the prohibited list, as natural origin does not guarantee safety or legality in sport.
IHSA Pharmacology & Medication Management 2
An athlete is prescribed a beta-2 agonist for exercise-induced bronchoconstriction.
Which form requires a Therapeutic Use Exemption (TUE) in WADA-governed sports?