2017 HCHB_digital

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Drugs in Sport Treating Athletes Medical professionals need to exercise caution when treating athletes because many medications are not permitted for use in sport. Athletes at any level may be subject to drug testing. Testing may be conducted at a competition or event or out-of-competition when an athlete is training, travelling or at home. Athletes have a responsibility to inform every doctor or specialist treating them that they are subject to drug testing in sport. Drug Free Sport NZ (DFSNZ) provides up-to-date information regarding medications to athletes so that they can alert medical professionals to their special needs. The Prohibited List Medications which are not permitted in sport are listed in the World Anti-Doping Agency’s Prohibited List which is published on January 1st each year. It is important to keep up-to-date with what’s included on this list. The list is available at www. drugfreesport.org.nz Checking Medications Medical professionals should always check the status of a medication before prescribing to an athlete. This can be done by: •• checking the New Zealand Formulary database (www.nzformulary.org.nz) for possible restrictions in sport •• visiting www.drugfreesport.org.nz/medication-check •• calling Drug Free Sport NZ on 0800 DRUGFREE (0800378437) •• texting the medication name or active ingredient to 4365 (texts cost 20c). Common Conditions If an athlete has one or more of the following conditions it is likely that prohibited substances will be part of the recommended treatment: •• ADHD •• asthma •• cardiovascular disease •• diabetes •• severe acne and other severe skin conditions •• severe hay fever or other allergic reactions. Athletes who require anaesthesia, surgery or dental work are also likely to require medication which is prohibited in sport. supporting the diagnosis in the event an adverse analytical finding results from testing. Please call Drug Free Sport NZ on 0800 DRUGFREE (0800 378 437) for further information. Supplements Drug Free Sport NZ advises athletes that they take supplements at their own risk. It warns athletes to be wary of supplements for the following reasons: •• supplements are not manufactured to the same rigorous standards as pharmaceuticals •• some supplements may be cross-contaminated with prohibited substances •• labelling laws are not the same in all countries meaning that some ingredients may not be listed •• manufacturing standards vary greatly around the world and some supplement manufacturers use phrases such as “pharmaceutical standards” or “approved by XXX sports league”. This does not mean they are safe for use in sports. Drug Free Sport NZ cannot determine the status of any supplement in sport, but can provide advice about the level of risk associated with particular brands or ingredients. Athletes should contact Drug Free Sport NZ for advice on supplements (0800 DRUGFREE) or use the organisation’s online supplement enquiry form at www.drugfreesport.org.nz/supplement-check Quick Reminders •• Ensure you check the status of all medications before administering them to athletes. •• If the medication is prohibited, check to see if there is an alternative that is permitted. If not, check that the athlete is aware a TUE may be required. •• If you have any queries, call 0800 DRUGFREE (378 437) for assistance •• Check Drug Free Sport NZ’s website for further information and advice on treating athletes: www.drugfreesport.org.nz Reviewed by Drug Free Sport NZ, March <strong>2017</strong>. Therapeutic Use Exemptions (TUEs) If international or national level athletes (as determined by DFSNZ) are prescribed a prohibited substance they must obtain a TUE before using the medication. This form must be submitted to Drug Free Sport NZ (or the athlete’s International Federation if applicable). The athlete has to wait for TUE approval before using the medication unless the situation is deemed an emergency whereby the athlete’s health is at great risk. In these circumstances a TUE application should be submitted as soon as possible once the situation is resolved. TUE forms are available at www.drugfreesport.org.nz Note: Athletes who are not competing at a national or international level can apply for a TUE retrospectively; however, they will require a full medical file Page 206 HEALTHCARE HANDBOOK <strong>2017</strong>-2018 References Charts
Common permitted and prohibited OTC medicines Cough, cold, flu, sore throat Diarrhoea or vomiting Hay fever Pain/inflammation/ headache Permitted Anaesthetic throat sprays Antihistamines (see hay fever below) Aspirin, benzydamine, or oral anti-inflammatories Cough medicines, eg: bromhexine, dextromethorphan, guaiphenesin, pholcodine Phenylephrine Electrolyte replacement therapies (eg, Enerlyte, Gastrolyte, Hydralyte) Loperamide (eg, Diamide, Imodium, Nodia) Prochlorperazine (eg, Antinaus), promethazine (Avomine), meclozine (Sea-Legs), scopolamine (Scopoderm TTS) All antihistamines (eg, Fexofast, Hayfexo, Levrix, Phenergan, Polaramine, Zyrtec) Glucocorticoid nasal sprays (eg, Beconase, Flixonase, Telnase) Oxymetazoline, xylometazoline (eg, Dimetapp, Otrivin) All non-steroidal anti-inflammatories (eg, aspirin, ibuprofen, diclofenac, naproxen) Paracetamol Tramadol Combination analgesics that include codeine with other permitted medicines (eg, Mersyndol, Nurofen Plus, Panadeine) Products containing caffeine (eg, Panadol Extra, Parafast Extra) Examples of prohibited medicines All pseudoephedrine products are prohibited in competition. DFSNZ recommends athletes consider using products that contain phenylephrine as a permitted alternative Products containing MORPHINE (eg, Gees Linctus) Alcohol is prohibited in-competition in certain sports – see Drug Free Sport NZ website for details All pseudoephedrine products are prohibited in competition Oral prednisone In-competition, all medicines containing morphine, pethidine, fentanyl, oxycodone, etc are prohibited Skin conditions Topical hydrocortisone preparations (eg, Derm-Aid) Oral glucocorticoids (eg, prednisone) are prohibited in-competition Note: Call 0800 DRUGFREE (378 437) for a full list of prescription medicines, or if unsure. A Guide To Commonly Prescribed Medicines And Their Status In Sport MEDICINE International athlete National athlete Other athletes Salbutamol by inhalation (eg, Respigen, Salamol, Ventolin)* Permitted Permitted Permitted Salmeterol by inhalation (eg, Meterol, Serevent)* Permitted Permitted Permitted eFormoterol by inhalation (eg, Oxis, Foradil, Symbicort, Vannair)* Glucocorticoids by inhalation (eg, Beclazone, Flixotide, Pulmicort) Permitted Permitted Permitted Permitted Permitted Permitted Terbutaline (eg, Bricanyl) TUE required from IF TUE required from DFSNZ TUE required retrospectively if a positive test occurs Systemic salbutamol (eg, Ventolin elixir) TUE required from IF TUE required from DFSNZ TUE required retrospectively if a positive test occurs Systemic glucocorticoids (eg, prednisone – oral, parenteral, intramuscular, rectal) TUE required from IF TUE required from DFSNZ TUE required retrospectively if a positive test occurs Nasal/eye/ear/topical corticosteroids Permitted Permitted Permitted Note: IF stands for the athletes’ International Federation – we advise International Level athletes to call 0800 DRUGFREE (378 437) for assistance when a TUE is required. *Thresholds exist for certain inhalers (for example, salbutamol has a threshold of 1600mcg per 24 hours or 800mcg per 12 hours. Once this threshold is exceeded, a positive test will be reported). Essentially, if inhalers are used as prescribed at standard prescription dosages, the threshold should not be exceeded. Page 207
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HEALTHCARE HANDBOOK incorporating t
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2017-2018 HEALTHCARE HANDBOOK PUBLI
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Index Common Disorders Acne--------
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Asthma and COPD CONTINUING OTC EDUC
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Head and scalp • Condition of hai
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HELP KIDS BE THEMSELVES AGAIN NEW L
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NUROFEN ZAVANCE* IS ABSORBED UP TO
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Acne Acne is a common skin problem
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Allergies An allergy occurs when th
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Asthma and COPD Asthma New Zealand
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Baby Feeding Breastfeeding is best
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Bites and Stings Bites and stings c
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Bruises, Scars, Spider Veins Bruise
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Childhood Diseases and Immunisation
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Page 32 and 33:
Page 34 and 35:
Page 36 and 37:
Childhood Pain and Baby Teething Pa
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Colds A cold is a contagious viral
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Cold Sores Cold sores are fluid-fil
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Constipation Constipation is the te
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Contraception & Sexual Wellbeing Co
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Contraception: Emergency Emergency
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Coughs: Dry Coughs are called dry o
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Coughs: Productive Coughs are consi
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Cuts, Abrasions and Blisters This t
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Cystitis [Bladder Infection] Cystit
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Dandruff Dandruff is a common condi
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Dermatitis/Eczema Dermatitis is a g
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Diabetes Diabetes is a condition in
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Diarrhoea and Vomiting Diarrhoea an
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Dry Skin Dry skin is skin that lack
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Ear Conditions Our ears allow us to
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Eye Conditions Almost two-thirds of
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Eye Conditions (continued) Type Sym
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Eyes: Contact Lenses Contact lenses
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Fever What is fever Fever is define
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Foot Care Common foot problems incl
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Fungal Infections: Superficial Supe
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Fungal Nail Infections (Onychomycos
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Gout Historically known as the “d
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Haemorrhoids Haemorrhoids (also cal
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Hair Loss Alopecia is the medical t
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Hay Fever Hay fever (also called in
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Hay Fever (continued) TREATMENT OPT
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Headache Headaches are common and c
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Head Lice Head lice (pediculosis ca
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Heart Health Cardiovascular (CV) di
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Indigestion, Heartburn and Gastriti
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Influenza Influenza (flu) is a comm
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Influenza (continued) TREATMENT OPT
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Iron Deficiency Iron is an essentia
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Irritable Bowel Syndrome Irritable
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Menopause Menopause - the “change
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Migraine Migraines are a type of se
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Muscular Aches, Pains and Tightness
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Nappy Rash Nappy rash is a red rash
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Oral Health Oral health disorders i
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Osteoarthritis Osteoarthritis is th
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Osteoporosis Osteoporosis (meaning
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Period Pain and Endometriosis Perio
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Poisonings Any substance that has t
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Pregnancy Tests and Supplements Hom
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Preventive Health There are certain
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Probiotics and Prebiotics Probiotic
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Psoriasis Psoriasis is a long-term
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Scabies Scabies is a very contagiou
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Shingles Shingles (herpes zoster) i
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Sinus and Nasal Problems Sinuses ar
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Sleep Problems and Snoring Sleep is
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Smoking Cessation Almost 5000 New Z
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Sore Throat Sore throats are very c
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Strains and Sprains Sprains and str
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Sun Care Sunburn Sunburn occurs fro
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Sun Care: Eye Protection Protecting
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Sweating: Excessive (Hyperhidrosis)
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Toothache Toothache is the term use
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Travel Health (including Vaccinatio
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Travel Sickness Travel, or motion,
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Urinary Incontinence Urinary incont
Page 162 and 163: Urticaria (Hives) Urticaria refers
Page 164 and 165: Vaginal Health The vagina is a clos
Page 166 and 167: Varicose Veins and Support Stocking
Page 168 and 169: Vitamins and Dietary Supplements Vi
Page 170 and 171: Warts Warts are benign (non-cancero
Page 172 and 173: Weight Loss Obesity has reached epi
Page 174 and 175: Worms Pinworms (Enterobius vermicul
Page 176 and 177: Wound Care Our skin acts as a barri
Page 178 and 179: Wound Care (continued) Wound type M
Page 180 and 181: Glossary WHAT DOES THAT WORD MEAN?
Page 182 and 183: Chapter References (continued) Diar
Page 184 and 185: Chapter References (continued) Gord
Page 186 and 187: Significant learning opportunity: W
Page 188 and 189: PharmacyToday A part of your everyd
Page 190 and 191: OTC Medicines: Interactions When se
Page 192 and 193: OTC Medicines: Interactions OTC Med
Page 198 and 199: OTC Medicines: Precautions OTC Medi
Page 200 and 201: OTC Medicines: Precautions OTC Medi
Page 202 and 203: OTC Medicines: Adverse Effects OTC
Page 204 and 205: Herbal Supplements: Interactions He
Page 214 and 215: Drugs in Aviation AVIATION - PRECAU
Page 216 and 217: Drugs in Pregnancy Drug use in preg
Page 218 and 219: NZ Support Groups ADHD Association
Page 220 and 221: NZ Support Groups New Zealand AIDS
Page 222 and 223: HEAT or INFLAMMATION Unlike heat ru
Page 224 and 225: OTC Products Over-the-counter produ
Page 226 and 227: OTC Products Index Foot Care - Fung
Page 228 and 229: »» Acne CRYSTADERM CREAM AFT PHAR
Page 230 and 231: »» Childhood Pain and Baby Teethi
Page 232 and 233: »» Colds BONNINGTON’S IRISH MOS
Page 234 and 235: CODRAL RELIEF MAX STRENGTH COLD & F
Page 236 and 237: OTRIVIN JUNIOR GLAXOSMITHKLINE CONS
Page 238 and 239: DULCOLAX SANOFI CONSUMER HEALTHCARE
Page 240 and 241: BENADRYL MUCUS RELIEF DOUBLE ACTION
Page 242 and 243: »» Dandruff COCO-SCALP AFT PHARMA
Page 244 and 245: EAR CLEAR WILSON CONSUMER PRODUCTS
Page 246 and 247: »» Foot Care - Fungal Infections
Page 248 and 249: TELFAST ORAL LIQUID SANOFI CONSUMER
Page 250 and 251: NUROFEN ZAVANCE RECKITT BENCKISER (
Page 252 and 253: MOOV HEAD LICE SOLUTION DOUGLAS PHA
Page 254 and 255: GAVISCON DUAL ACTION LIQUID RECKITT
Page 256 and 257: CODRAL COLD & FLU + COUGH JOHNSON &
Page 258 and 259: »» Irritable Bowel Syndrome GASTR
Page 260 and 261: VOLTAREN EMULGEL GLAXOSMITHKLINE CO
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TURMERIC EXTRA STRENGTH GOOD HEALTH
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PREGNOSIS EARLY PREGNANCY TEST DIP
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»» Sexual Wellbeing - Contracepti
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SUDAFED PE SINUS DAY + NIGHT RELIEF
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NICORETTE INHALATOR JOHNSON & JOHNS
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STREPSILS PLUS LOZENGES RECKITT BEN
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TRAVACALM TRAVEL BAND WILSON CONSUM
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CRYSTADERM CREAM AFT PHARMACEUTICAL
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An ENHANCED ELearning Experience As
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Product Index ANIME LUBRICANT 50ML-
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Manufacturer’s Index AFT Pharmace
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Topiramate Actavis Topiramate 25mg,
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