Plasma Expanders (PEx)
Plasma expanders are used to increase (expand) the volume of plasma in the blood. Examples include Haemaccel, Albumex, Gelofusine. They are mainly used in medicine to replace fluid in cases of severe shock, as may occur with blood or fluid loss in surgery.
Some athletes may use PEx in an attempt to mask the effects of EPO.
Side effects
Side effects include allergic reactions and anaphylactic shock (a severe form of generalised allergic reaction that can result in death).
Detection
PEx can be detected in the urine using gas chromotography - mass spectrometry techniques.
Artificial oxygen carriers
Artificial oxygen carriers are chemicals used to increase the ability to carry extra oxygen in the blood. Examples include perflurocarbons (PFCs), haemoglobin based oxygen carriers (HBOCs) and liposome (fatty membrane) encapsulated haemoglobins (LEHs).
Artificial oxygen carriers are of potential when human blood is not available, the risk of blood infection is high or when time to properly undertake cross-matching donated blood with a recipient, is short. Such products are still in development and although improvements are being made, more research and development is needed before these products will be useful to humans in clinical medicine.
There have been some reports of athletes using these products in an attempt to increase the oxygen carrying capacity of their blood, however concrete evidence to support these claims is unavailable and these drugs are still not in general use. .
Side effects
Side effects significantly vary between the PFCs and the HBOCs. They can be most serious as it is difficult to measure correct doses.
Side effects of PFCs include:
A transient fever
Reduction in the platelet count
Potential overloading of phagocyte cells
Side effects of HBOCs include:
Hypertension
Vasoconstriction
Kidney damage
Iron overload
Detection
PFCs can be detected using a breath test or in the blood using gas chromotography - mass spectrometry techniques.
It is presumed that artificial oxygen carriers would be detectable in blood samples. There is, however a lack of data on use by athletes and as such this area requires further study.
Status in sport
Artificial oxygen carriers and plasma expanders are banned under the Olympic Anti-doping Code ‘Prohibited Classes of Substances and Prohibited Methods’.
Pharmacological, chemical and physical manipulation
Pharmacological, chemical and physical manipulation is the use of substances or methods that attempt to alter or substitute the urine sample.
Examples of these prohibited methods are:
catheterisation (drawing off urine from the bladder with a special tube);
urine substitution or swapping;
tampering with and inhibition of renal excretion (eg. by masking agents such as Probenecid and related compounds, Bromantan, and epitestosterone administration.*)
Epitestosterone maybe given to try to mask testosterone administration.
Status in sport
Pharmacological, chemical and physical manipulation is banned under the Olympic Movement Anti-Doping Code Prohibited Classes of Substances and Prohibited Methods.
Restricted substances
Restricted substances are:
banned in some forms;
only tested for in some sports; or
only permitted under certain conditions.
