Maria Sharapova is a Russian professional tennis player who has won five Grand Slam championships. On January 26, 2016, she completed a drug test and in June 2016 her career took a turn for the worse, she received a letter informing her that she had tested positive for the drug meldonium, which goes by the trade name Mildronate (Meher, Das, & Mahanty, 2017). Meldonium was classified by the World Anti-Doping Agency on January 1, 2016 as a performance-enhancing drug in the metabolic modulator class and was previously included in the monitoring program (Meldonium, 2016). This drug has become a big problem for many athletes as as of April 13, 2016, 170 athletes had tested positive for the presence of meldonium in their systems (Meldonium, 2016). Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an Original Essay This topic relates to drug testing because routine drug testing performed by the World Anti-Doping Agency found that all of these athletes were using meldonium and assigned them what they believed were the appropriate consequences. Maria Sharapova was initially given a two-year suspension from the sport of tennis by the International Tennis Federation. Meldonium is an over-the-counter drug in Eastern Europe but is not approved in North America or Western Europe. In Eastern Europe this drug was originally invented as a growth-promoting agent for animals, but over the past 40 years it has been found to have anti-ischemic, 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 was banned by the World Anti-Doping Agency is because it is believed to have performance-enhancing effects due to its ability to change the way carnitine is metabolized in the body and its ability to increase metabolic rate relative to glucose oxidation. This drug is effective because it binds to the enzyme gamma-butyrobetaine hydroxylase and prevents it from biosynthesizing carnitine, thus reducing plasma carnitine levels. This affects the body because carnitine transports fatty acids into the mitochondria for energy and with lower plasma carnitine levels this does not happen. and this leads to a vasodilatory 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 are believed to come from. An increase in the relative metabolic rate of glucose oxidation requires less oxygen to complete the process than fatty acid oxidation and this can lead to the enhancement of cardiac myocytes also known as muscle cells in ischemic conditions (Meldonium, 2016). Although this drug has many benefits for heart health and performance enhancement, it also carries some risks. Due to the decrease in plasma levels of carnitine there is the possibility of a deficiency. A carnitine deficiency can cause muscle pain, fatigue, muscle weakness, cramps during exertion, and can induce hypoketotic hypoglycemia, which can be unfavorable for nerve and muscle function (Jargin, 2016). In addition to these risks, studies conducted in the Soviet Union have shown that carnitine exerts a cardioprotective effect in cardiomyopathy, helps reduce infarct size, prevents arrhythmias, improves survival in patients with myocardial infarction, and increases tolerance to exercise in patients with angina eheart failure. (Buszewski and Noga). The reason this is important is because when your body has a carnitine deficiency, these positive effects of carnitine may not occur putting your body at risk if you suffer from certain illnesses or diseases. Urine samples are used to test athletes for meldonium use. After the urine has been collected, a liquid chromatography-tandem mass spectrometry assay with hydrophilic interaction detection is initially used. Next, a high resolution/high precision hydrophilic interaction liquid chromatography mass spectrometry test is used to confirm the suspect results of the initial tests (Gorgens, Guddat, Dib, Geyer, Schanzer & Thevis, 2015). To break down the testing technique into more understandable terms, they 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., & 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 accurate techniques that the World Anti-Doping Agency can use to ensure fair and accurate results for all athletes tested. There is one major complication with meldonium that has caused some debate. This means that there was limited data on the urinary excretion of meldonium when it was added to the list of banned substances. When meldonium was first introduced as a banned drug, several studies involving laboratories accredited by the World Anti-Doping Agency were conducted, but the results had yet to be published. The information they had from the preliminary results of the studies showed higher urinary concentrations more than 10 μg/mL remained in the system for up to 72 hours and this was the first elimination phase. This was followed by a long-term excretion or second elimination phase, resulting in concentrations of up to approximately 2 μg/mL over the next three weeks. Finally, long-term urinary excretion of less than 1 μg/ml up to several hundred ng/ml may persist for a number of weeks and in the order of tens of ng/ml for a few months. Due to a lack of clear scientific evidence, a jury may find that an athlete who ingested meldonium before January 1, 2016 may not have known or suspected that meldonium would still be present in his or her body as of January 1, 2016. To combat this problem guidelines have been established. The guidelines state: 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- The anti-doping agency may believe that there is no fault or negligence on the part of the athlete since the results of ongoing excretion studies are necessary to determine the time of ingestion. That said, if the sample tested positive during the competition he would still be disqualified (Notice-Meldonium, April 2016). An updated notice was released on June 30, 2016 after they were (2016).