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With increasing vigilance, the governing bodies of elite sports such as the Olympics keep a strict eye on the use of all kinds of substances to ensure a level playing field for competitive athletes. Every governing body has its own rules, different rules apply to each sport within that body, and the banned substances lists can change every year.

So what are primary care physicians and pediatricians supposed to do when they have to treat an elite athlete who gets sick in-season?

, an internist at Southern Methodist University in Dallas, treats many of SMU's NCAA Division I athletes, some of whom are also Olympians. Davis told 乌鸦传媒 that the rules are different between the NCAA and the International Olympic Committee (IOC) when it comes to asthma and cold medications. He recommended checking on for substance guidelines when treating a competitive athlete.

are physicians with Barton Health's Tahoe Orthopedics and Sports Medicine in South Lake Tahoe, Calif. They are both in Sochi, Russia, this month, volunteering as team physicians at the 2014 Winter Olympics.

Orr gave 乌鸦传媒 several tips for treating competitive athletes, noting, "Every time I prescribe a medication for an athlete, I check to see if it is on the prohibited list. Every time."

"There is a website, , that can look up different medications by ingredient or by its trade name, such as acetaminophen versus Tylenol," he continued. "You can also look up medications from other countries that may have ingredients different from what we would expect in a similar medication in the States."

The World Anti-Doping Agency (WADA) calls its banned substances list -- and it's a document that Orr recommends for reference. "Know if your athlete is subjected to drug testing and, if so, is it only in-competition, or both in- and out-of-competition testing," Orr said.

For athletes with an ongoing medical condition, Orr notes the option of a .

"Educate your athlete and tell them to beware of supplements -- they are a notorious source for unlisted ingredients that have resulted in failed drug tests," Orr warned.

Born out of the need to have an international, overarching anti-doping authority, WADA is governed by changing leadership from a combination of and international sports federations.

Obvious violations of "the Code" include and steroids, but the United States Anti-Doping Agency also warns against having around game day.

Prior to rule changes in 2004, drinking a large cola before competition could put an athlete over the limit for "in-competition" caffeine intake. But, at least for now, WADA's main focus seems to be on real performance-enhancing cheats, as opposed to popping an ibuprofen after practice.

"Probably the most important component for the athlete is access to timely medical care," Orr added. "When an athlete is in their competition season, a delay of just a few days in starting treatment may result in a missed competition."

Prime Time is a blog by staff writer Sarah Wickline Wallan for readers with an interest in primary care.

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