Portuguese teenager Gustavo Madureira has been given a warning after testing positive for Terbutaline (Class S.3 Beta-2 Agonists) in an in-competition test in Portugal. Why the athlete should receive only a warning may come down to ignorance over medicines available to asthma sufferers, though the case raises concerns. 

Terbutaline is used to delay preterm labour in pregnant women for 48 hours to allow for fetal lung maturity through steroid injections. Among warnings that accompany the drug for proper use, is that there is "potential for serious internal heart problems and death." The American College of Obstetricians and Gyneacologists also discourages the use of terbutaline for preventing preterm labour. 

Since Madureira is a boy, we assume he wasn't pregnant and perhaps this is why the substance was found: Terbutaline is used as a fast-acting bronchodilator (often used as a short-term asthma treatment). The inhaled form of terbutaline starts working within 15 minutes and can last up to 6 hours.

Terbutaline is not approved by the Food and Drug Administration in the USA. How it came to be in the hands of a fit young athlete is for his doctors in Portugal and the Disciplinary Board of the Portuguese Swimming Federation, which imposed a warning on the athlete, to explain - at least you would want that if your name happened to be Senhor and Senhora Madureira. They might also wish to ask why better advice on what athletes can take to alleviate asthma was not available.

Meanwhile, Madureira is the third swimmer to be sanctioned for doping this year, after Litvina Yuliya (KAZ) tested positive to the substance Methylhexaneamine (Class S.6 Stimulants) and was suspended for 6 months, and Barbara Benke (BRA) for the substance Isometheptene (Class S.6 Stimulants) that attracted a 4-month penalty. Both tests were conducted in March.

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