Int J Sports Med 2006; 27(11): 919-925
DOI: 10.1055/s-2006-923811
Clinical Sciences

© Georg Thieme Verlag KG Stuttgart · New York

Ample Use of Physician-Prescribed Medications in Finnish Elite Athletes

A. Alaranta1 , H. Alaranta2 , M. Heliövaara3 , M. Airaksinen1 , I. Helenius4
  • 1Division of Social Pharmacy, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
  • 2Käpylä Rehabilitation Centre, Helsinki, Finland
  • 3National Public Health Institute, Helsinki, Finland
  • 4Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
Further Information

Publication History

Accepted after revision: November 28, 2005

Publication Date:
14 February 2006 (online)

Abstract

The present study aimed at determining the use of physician-prescribed medication in a large number of elite athletes compared with a representative control sample of the general population. Of all the athletes (N = 494) financially supported by the National Olympic Committee, 446 completed a structured questionnaire (response rate 90.3 %) in 2002. A control group (N = 1503, response rate 80.1 %) comprised an age-matched sample from the population-based study collected by the National Public Health Institute. Any prescribed medication was used by 34.5 % of the athletes and 24.9 % of the controls during the past seven days. The most frequently reported physician-prescribed medications among athletes during the previous seven days were anti-allergic medicines (12.6 % of the respondents), non-steroidal anti-inflammatory drugs (NSAIDs; 8.1 %), anti-asthmatic medicines (7.0 %), and oral antibiotics (2.7 %). The adjusted odds ratios (95 % CI) for the physician-prescribed medications used during the previous seven days was 2.42 (1.69 - 3.46), 3.63 (2.25 - 5.84), 3.42 (2.05 - 5.70), and 2.15 (1.03 - 4.45) for use of anti-allergic medication, NSAIDs, anti-asthmatic medication, and oral antibiotics, respectively, in the athletes compared with controls. Every fifth athlete reported some NSAID-related adverse effect. In conclusion, the athletes used NSAIDs, antibiotics, anti-asthmatic and anti-allergic medication significantly more often than a representative sample of age-matched controls. All these medicines have potential adverse effects that may have a deleterious impact on the maximum exercise performance of elite athletes. Adverse effects were commonly reported in connection with NSAID use.

References

  • 1 Adirim T A, Cheng T L. Overview of injuries in the young athlete.  Sports Med. 2003;  33 75-81
  • 2 Alaranta A, Alaranta H, Heliövaara M, Alha P, Palmu P, Helenius I. Allergic rhinitis and pharmacological management in elite athletes.  Med Sci Sports Exerc. 2005;  37 707-711
  • 3 Alaranta A, Alaranta H, Palmu P, Alha P, Pietilä K, Heliövaara M, Helenius I. Asthma medication in Finnish Olympic athletes: No signs of inhaled β2-agonist overuse.  Med Sci Sports Exerc. 2004;  36 919-924
  • 4 Altman R D, Latta L L, Keer R, Renfree K, Hornicek F J, Banovac K. Effect of nonsteroidal anti-inflammatory drugs on fracture healing: a laboratory study in rats.  J Orthop Trauma. 1995;  9 392-400
  • 5 Baker J, Cotter J D, Gerrard D F, Bell M L, Walker R J. Effects of indomethacin and celecoxib on renal function in athletes.  Med Sci Sports Exerc. 2005;  37 712-717
  • 6 Bennell K, Brukner P. How should you treat a stress fracture?. MacAuley D, Best T Evidence Based Sports Medicine. London; BMI Books 2002: 491-517
  • 7 Berglund B, Sundgot-Borgen J. Sports medicine update.  Scand J Med Sci Sports. 2001;  11 369-371
  • 8 Bondesen B A, Mills S T, Kegley K M, Pavlath G K. The COX‐2 pathway is essential during early stages of skeletal muscle regeneration.  Am J Physiol. 2004;  287 C475-C483
  • 9 Buckwalter J A. Pharmacological treatment of soft-tissue injuries.  J Bone Joint Surg. 1995;  77 A 1902-1914
  • 10 Burd T A, Lowry K J, Anglen J O. Indomethacin compared with localized irradiation for the prevention of heterotopic ossification following surgical treatment of acetabular fractures.  J Bone Joint Surg. 2001;  83 A 1783-1788
  • 11 Corrigan B, Kazlauskas R. Medication use in athletes selected for doping control at the Sydney Olympics (2000).  Clin J Sports Med. 2003;  13 33-40
  • 12 Crofford L J, Wilber R L, Ristimäki A P, Sano H, Remmers E F, Epps H R, Hla T. Cyclooxygenase-1 and -2 expression in rheumatoid synovial tissues: effects of interleukin-1beta, phorbol ester, and corticosteroids.  J Clin Invest Med. 1994;  93 1095-1101
  • 13 Elder C L, Dahners L E, Weinhold P S. A cyclooxygenase-2 inhibitor impairs ligament healing in the rat.  Am J Sports Med. 2001;  29 801-805
  • 14 Endo K, Sairyo K, Komatsubara S, Sasa T, Egawa H, Yonekura D, Adachi K, Ogawa T, Murakami R, Yasui N. Cyclooxygenase-2 inhibitor inhibits the fracture healing.  J Physiol Anthropol Appl Human Sci. 2002;  21 235-238
  • 15 Gierer P, Mittlmeier T, Bordel R, Schaser K D, Gradl G, Vollmar B. Selective cyclooxygenase-2 inhibition reverses microcirculatory and inflammatory sequelae of closed soft-tissua trauma in an animal model.  J Bone Joint Surg. 2005;  87 A 153-160
  • 16 Gilroy D W, Tomlinson A, Willoughby D A. Differential effects of inhibition of isoforms of cyclooxygenase (COX‐1, COX‐2) in chronic inflammation.  Inflamm Res. 1998;  47 79-85
  • 17 Gretzer B, Knorth H, Chantrain M, Barbera L, Willburger R E, Wittenberg R H, Peskar B M. Effects of diclofenac and L‐745, 337, a selective cyclooxigenase-2 inhibitor, on prostaglandin E2 formation in tissue from human colonic mucosa and chronic bursitis.  Gastroenterology. 1998;  114 A139
  • 18 Griffiths M L. End-stage renal failure caused by regular use of anti-inflammatory analgesic medication for minor sports injuries.  S Afr Med J. 1992;  81 377-378
  • 19 Hawkey C J, Langman M S. Non-steroidal anti-inflammatory drugs: overall risks and management. Complementary roles for COX‐2 inhibitors and proton pump inhibitors.  Gut. 2003;  52 600-608
  • 20 Helbling A, Jenoure P, Muller U. The incidence of hay fever in leading Swiss athletes.  Schweiz Med Wschr. 1990;  120 231-236
  • 21 Helenius I, Rytilä P, Sarna S, Lumme A, Helenius M, Remes V, Haahtela T. Effect of continuing or finishing high-level sports on airway inflammation, bronchial hyperresponsiveness, and asthma: a 5-year prospective follow-up study of 42 highly trained swimmers.  J Allergy Clin Immunol. 2002;  109 962-968
  • 22 Helenius I J, Tikkanen H O, Haahtela T. Association between type of training and risk of asthma in elite athletes.  Thorax. 1997;  52 157-160
  • 23 Irving R A, Noakes T D, Raine R I, Van Zyl Smit R. Transient oliguria with renal tubular dysfunction after a 90 km running race.  Med Sci Sports Exerc. 1990;  22 756-761
  • 24 Kujala U M, Sarna S, Kaprio J. Use of medications and dietary supplements in later years among male former top-level athletes.  Arch Int Med. 2003;  163 1064-1068
  • 25 Kujala U M, Taimela S, Antti-Poika I, Orava S, Tuominen R, Myllynen P. Acute injuries in soccer, ice hockey, volleyball, basketball, judo, and karate: analysis of national registry data.  BMJ. 1995;  311 1465-1468
  • 26 Maiolo C, Fuso L, Todaro A, Anatra F, Boniello V, Basso S, De Lorenzo A, Pistelli R. Asthma and atopy in elite athletes.  Int J Sports Med. 2003;  24 139-144
  • 27 Nieman D C. Exercise effects on systemic immunity.  Immunol Cell Biol. 2000;  78 496-501
  • 28 Nystad W, Harris J, Sundgot Borgen J. Asthma and wheezing among Norwegian elite athletes.  Med Sci Sports Exerc. 2000;  32 266-270
  • 29 Seibert K, Zhang Y, Leahy K, Hauser S, Masferrer J, Isakson P. Distribution of COX‐1 and COX‐2 in normal and inflamed tissues.  Adv Exp Med Biol. 1997;  400 A 167-170
  • 30 Shoor S. Athletes, nonsteroidal anti-inflammatory drugs, coxibs, and the gastrointestinal tract.  Curr Sports Med Reports. 2002;  1 107-115
  • 31 Simon L S. Actions and toxicity of non-steroidal anti-inflammatory drugs.  Curr Opin Rheumat. 1996;  5 169-175
  • 32 Szczeklik A, Gryglewski R J, Czerniawska-Mysik G, Pieton R. Asthmatic attacks induced in aspirin-sensitive patients by diclofenac and naxopren.  BMJ. 1977;  2 231-232
  • 33 Thorsson O, Rantanen J, Hurme T, Kalimo H. Effects of nonsteroidal antiinflammatory medication on satellite cell proliferation during muscle regeneration.  Am J Sports Med. 1998;  26 172-176
  • 34 Verrico M M, Weber R J, McKaveney T P, Ansani N T, Towers A L. Adverse drug events involving COX‐2 inhibitors.  Ann Pharmacother. 2003;  37 1203-1213
  • 35 Vitting K E, Nichols N J, Seligson G R. Naproxen and acute renal failure in a runner.  Ann Intern Med. 1986;  105 44
  • 36 Walker R J, Fawcett J P, Flannery E M, Gerrard D F. Indomethacin potentiates exercise-induced reduction in renal hemodynamics in athletes.  Med Sci Sports Exerc. 1994;  26 1302-1306
  • 37 Wallace J L, Chapman K, McKnight W. Limited anti-inflammatory efficacy of cyclo-oxygenase-2 inhibition in carrageenan-airpouch inflammation.  Br J Pharmacol. 1999;  126 1200-1204
  • 38 Weiler J M. Medical modifiers of sport injury. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) in sports soft-tissue injury.  Clin Sports Med. 1992;  11 625-644

M.Sc. (Pharm) Antti Alaranta

Division of Social Pharmacy, Faculty of Pharmacy
University of Helsinki

Tammelankatu 8 B 10

04430 Järvenpää

Finland

Fax: + 35 89 19 15 98 84

Email: antti.alaranta@helsinki.fi.

    >