beta-Adrenergic stimulation

Two groups of substances which stimulate the adrenergic system are listed as prohibited by the World Anti-Doping Agency. Stimulants are prohibited in-competition only and beta(2)-agonists are prohibited in- and out-of-competition. While beta(2)-agonists act directly on the target receptors, sympathomimetic amines can exert their action directly and indirectly. Due to differences in pharmacology but mainly due to differences in administered dose, differences in detection methods between both groups of substances exist although preparation is similar and consists of an extraction at basic pH. Gas chromatography coupled to mass spectrometry has been the detection methodology of choice for several decades. However, the importance of liquid chromatography-mass spectrometry as a preferred detection methodology is rapidly increasing, especially for the detection of beta(2)-agonists and new additions to the list of prohibited stimulants, such as modafinil. Pharmacology, metabolism and detection of both groups of prohibited substances will be discussed.