Maria Sharapova is a Russian professional tennis player who has won five Grand Slam championships. On January 26, 2016, she took a drug test and in June 2016, her career took a negative turn. She received a letter informing her that she had tested positive for meldonium, a drug known by the brand name mildronate (Meher, Das, & Mahanty, 2017). Meldonium was classified as a performance-enhancing drug in the metabolic modulator class by the World Anti-Doping Agency on January 1, 2016 and was previously part of the monitoring program (Meldonium, 2016). This drug has become a major problem for many athletes since as of April 13, 2016, 170 athletes had tested positive for the presence of meldonium in their system (Meldonium, 2016). Say no to plagiarism. Get a tailor-made essay on “Why violent video games should not be banned”? Get the original essay This topic concerns drug testing because routine drug testing by the World Anti-Doping Agency has detected all of these athletes using meldonium and assigned them what they believed to be appropriate consequences. Maria Sharapova was initially suspended for two years from the sport of tennis by the International Tennis Federation. Meldonium is an over-the-counter medication in Eastern Europe, but is not approved in North America or Western Europe. In Eastern Europe, this drug was originally invented as an animal growth-promoting agent, but over the past 40 years it has been found to have anti-ischemic and cardioprotective effects and the ability to increase sperm motility and sexual performance (Meher, Das and Mahanty). , 2017)(Gorgens, Guddat, Dib, Geyer, Schanzer & Thevis, 2015). The reason this drug has been banned by the World Anti-Doping Agency is because it is believed to have performance-enhancing effects due to its ability to alter the way carnitine is metabolized in the body and its ability to increase the relative metabolic rate of glucose oxidation. This medication is effective because it binds to the enzyme gamma-butyrobetaine hydroxylase and prevents it from biosynthesizing carnitine, thereby decreasing plasma carnitine levels. This affects the body because carnitine transports fatty acids into the mitochondria for energy, which does not happen with lower plasma carnitine levels. and this leads to a vasodilator response. The other effect of meldonium is that it increases the relative metabolic rate of glucose oxidation and this is where most of the performance enhancing benefits would come from. An increase in the relative metabolic rate of glucose oxidation requires less oxygen to complete the process than fatty acid oxidation, which may lead to the enhancement of cardiac myocytes also called muscle cells under ischemic conditions (Meldonium, 2016). Although this medication has many heart health and performance-enhancing benefits, it also carries some risks. Due to decreased plasma carnitine levels, there is a risk of deficiency. Carnitine deficiency can cause muscle pain, fatigue, muscle weakness, exercise cramps and can induce hypoketotic hypoglycemia, which can be unfavorable to nerve and muscle function (Jargin, 2016). In addition to these risks, some studies carried out in the Soviet Union have shown that carnitine exerts a cardioprotective effect in cardiomyopathy, that it helps to reduce the size of the infarct, that it prevents arrhythmias, that it improves the survivalin patients with myocardial infarction and increases exercise tolerance in patients with angina and heart failure. (Buszewski and Noga). The reason this is important is that when your body is deficient in carnitine, these positive effects of carnitine may not occur, putting your body at risk if you suffer from certain diseases. To test athletes for the use of meldonium, urine samples are used. After urine is collected, a liquid chromatography-tandem mass spectrometry hydrophilic interaction test is used for initial detection. After that, a high-resolution, high-precision hydrophilic interaction liquid chromatography mass spectrometry test is used to confirm the suspicious initial test results (Gorgens, Guddat, Dib, Geyer, Schanzer & Thevis, 2015). To divide the testing technique into more understandable terms, I have defined hydrophilic interaction liquid chromatography, tandem mass spectrometry, and high-resolution/high-precision mass spectrometry below. Hydrophilic interaction liquid chromatography is a powerful separation technique that separates polar compounds on polar stationary phases. This technique has become very popular in bioanalytical applications because drugs and their metabolites such as meldonium are often polar structures (Buszewski, B. and Noga, S) (Meldonium). Tandem mass spectrometry is a technique used to break down selected ions into fragments. to reveal aspects of chemical structure (Tandem Mass Spectrometry, 2015). Finally, high resolution/high precision mass spectrometry is defined as an instrument capable of distinguishing ions that differ by only a fraction of a mass unit (High Resolution, 2007). Overall, these are very precise techniques that the World Anti-Doping Agency can use to ensure fair and accurate results for all athletes tested. There is one main complication related to meldonium that has sparked some debate. Indeed, there were limited data on the urinary excretion of meldonium at the time of its addition to the prohibited list. When meldonium was first introduced as a banned drug, several studies were underway involving laboratories accredited by the World Anti-Doping Agency, but the results had not yet been published. The information they had from preliminary study results showed higher urinary concentrations. more than 10 μg/mL remained in the system for up to 72 hours and this was the first phase of elimination. This was followed by long-term excretion or a second elimination phase, yielding concentrations up to approximately 2 μg/mL over the next three weeks. Finally, long-term urinary excretion below 1 μg/mL up to several hundred ng/mL could persist for several weeks and in the low tens of ng/mL for a few months. Due to the lack of clear scientific evidence, a hearing panel could conclude that an athlete who ingested meldonium before January 1, 2016 may not have known or suspected that meldonium would still be present in their body afterward. from January 1, 2016. To combat this problem, guidelines have been put in place. The guidelines stated: If the concentration is between 1 and 15 μg/mL and the test was performed before March 1, 2016, or if the concentration is less than 1 μg/mL and the test was performed after March 1, 2016, the world anti-doping agency may conclude that there is no reason for misconduct or. (2016).