We examined urine and serum concentrations after therapeutic use of single and repetitive doses of inhaled and supratherapeutic oral use of terbutaline. We compared the concentrations in 10 asthmatics and 10 healthy subjects in an open-label, cross-over study with 2 mg inhaled and 10 mg oral terbutaline on 2 study days. Further, 10 healthy subjects were administrated 1 mg inhaled terbutaline in 4 repetive doses with total 4 mg. Blood samples were collected at baseline and during 6 h after the first inhalations. Urine samples were collected at baseline and during 12 h after the first inhalations. Median (IQR) urine concentrations peaked in the period 0-4 h after inhalation with Cmax 472 (324) ng/mL in asthmatics and 661 (517) ng/mL in healthy subjects, and 4-8 h after oral use with Cmax 666 (877) ng/mL in asthmatic and 402 (663) ng/mL in healthy subjects. In conclusion we found no significant differences in urine and serum concentrations between asthmatic and healthy subjects. We compared urine and serum concentrations after therapeutic inhaled doses and supratherapeutic oral doses and observed significant statistical differences in both groups but found it impossible to distinguish between therapeutic and prohibited use based on doping tests with urine and blood samples.
Two- and one-leg extension strengths were compared in 155 female and male, untrained and trained (eight bicyclists, 38 weight-lifters) subjects and in a polio patient with almost no strength in one leg. On average two-leg strength was 82 +/- 1.3% (SE) of the sum of the strength of the right and left legs (leg-strength ratio) with no significant difference between the untrained and trained subjects. In the polio patient two-leg strength was lower than the strength of the strongest leg. A similar leg-strength ratio was found when measurements were made with a knee angle of 150 degrees (n = 128) and 90 degrees (n = 25). The ratio did not change when re-determined after 1 year (n = 9). Moderate changes in the subjects' position during measurements did not affect one-leg strength (n = 13). However, familiarization with the experimental apparatus increased the leg-strength ratio from 80 +/- 2.5% to 97 +/- 2.9% (P less than 0.01) (n = 18). In contrast, two-arm extension strength was similar to the sum of the strength of the right and left arms (n = 15). The results demonstrate that two-leg strength in general is lower than the sum of the strength of the right and left legs, and that this phenomenon is found even after intensive endurance or strength training. However, familiarization with the experimental apparatus can increase the relative two-leg strength which suggests that muscle strength in man may be limited by the central nervous systems' ability to activate maximally all synergistic muscles and/or to control antagonistic muscles.
We found no significant difference in pharmacokinetic profile of inhaled and oral salbutamol between elite athletes with asthma and nonasthmatic subjects. Our results indicate that urine salbutamol concentrations should be corrected for urine specific gravity when evaluating doping cases.
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