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Although the excessive use of certain performance-enhancing drug (PED) classes is associated with clear health risks, current evidence on PED-related cardiovascular (CV) risk is primarily derived from retrospective reports, small cohorts, or illicit use, leaving major gaps in mechanistic understanding and doseresponse relationships in performance enhancement, well-being, and rehabilitation purposes

132 Advancements in pharmacokinetic optimizationparticularly in enhancing bloodbrain barrier permeabilityare expected to accelerate the transition of these agents from metabolic to neuroprotective indications

The majority of recommendations propose discontinuing semaglutide 7 to 12 weeks preoperatively to reduce risks such as delayed gastric emptying

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