Over the Counter Drugs: Decongestants & NSAIDs
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Questions and Answers

What is the primary mechanism by which decongestants reduce nasal congestion?

  • Acting as CNS depressants to reduce CNS stimulation
  • Constricting the dilated arterioles and reducing the blood flow to engorged nasal vascular beds (correct)
  • Causing the dilated arterioles to expand and increase blood flow to nasal vascular beds
  • Stimulating the beta-adrenergic receptor sites on vascular smooth muscles

What is the main reason for discontinuation of phenylpropanolamine (PPA) from pharmaceutical products?

  • Risk of seizures
  • Risk of psychosis
  • Risk of haemorrhagic stroke (correct)
  • Risk of hypertension

Which compound is a stimulant of both alpha and beta adrenergic receptors?

  • Ephedrine (correct)
  • Naphazoline
  • Pseudoephedrine
  • Phenylpropanolamine (PPA)

Which compound is a powerful alpha2-adrenergic receptor stimulant?

<p>All of the above (D)</p> Signup and view all the answers

What are the common toxic manifestations of decongestant toxicity?

<p>CNS stimulation, hypertension, and tachycardia (A)</p> Signup and view all the answers

What is the primary difference between ephedrine and pseudoephedrine in terms of adrenergic receptor activity?

<p>Ephedrine has only 25% of the adrenergic receptor activity of pseudoephedrine (C)</p> Signup and view all the answers

Which compound was discontinued from all pharmaceutical products due to the risk of haemorrhagic stroke?

<p>Phenylpropanolamine (PPA) (C)</p> Signup and view all the answers

What is the significant risk associated with phenylpropanolamine use, particularly among women?

<p>Increased risk of haemorrhagic stroke (C)</p> Signup and view all the answers

What are the serious manifestations of decongestant toxicity?

<p>Seizures, severe dysrhythmias, and cerebral haemorrhage (D)</p> Signup and view all the answers

What is the distinguishing feature of phenylpropanolamine in terms of beta-adrenergic receptor activity?

<p>'Phenylpropanolamine has no beta-adrenergic receptor activity' (D)</p> Signup and view all the answers

What type of dose used for phenylpropanolamine (PPA) is greater in appetite suppression compared to cough and cold preparations?

<p>Higher dose for appetite suppression (D)</p> Signup and view all the answers

What is the most common drug involved in overdose, registering approximately 60% of all analgesic exposures?

<p>Acetaminophen (D)</p> Signup and view all the answers

Which substance is the antidote for acetaminophen poisoning?

<p>N-Acetylcysteine (C)</p> Signup and view all the answers

What does chronic overuse of imidazoline decongestants result in?

<p>Reactive vasodilation of the nasal mucosa (D)</p> Signup and view all the answers

What is the most common cause of liver failure in the U.S.?

<p>Acetaminophen (D)</p> Signup and view all the answers

Which substance may cause significant hypertension and reflex bradycardia?

<p>Phenylpropanolamine (B)</p> Signup and view all the answers

What is the result of the production of the reactive intermediate, N-acetyl-p-benzoquinoneimine (NAPQI) metabolite?

<p>Hepatotoxic sequelae (D)</p> Signup and view all the answers

What does binding of NAPQI to hepatocyte membranes and sulfhydril proteins account for?

<p>Hepatotoxic sequelae (A)</p> Signup and view all the answers

What is recommended to effectively bind salicylates and to prevent intestinal obstruction due to concretions?

<p>Activated charcoal and cathartics (A)</p> Signup and view all the answers

What enhances ASA elimination by alkalinizing the urine while simultaneously reversing metabolic acidosis?

<p>Sodium bicarbonate administration (D)</p> Signup and view all the answers

What substance restores glutathione reserves by providing sulfhydric donors for the eventual detoxification of NAPQI?

<p>N-Acetylcysteine (B)</p> Signup and view all the answers

What is the most common drug involved in overdose, registering approximately 60% of all analgesic exposures?

<p>Acetaminophen (B)</p> Signup and view all the answers

What does chronic use or with large doses of acetaminophen lead to?

<p>Depletion of glutathione stores (B)</p> Signup and view all the answers

What are the primary toxic manifestations of decongestant toxicity?

<p>CNS stimulation, hypertension, tachycardia</p> Signup and view all the answers

Which compound is a powerful alpha2-adrenergic receptor stimulant?

<p>Naphazoline, oxymetazoline, tetrahydrozoline, xylometazoline</p> Signup and view all the answers

What is the distinguishing feature of phenylpropanolamine in terms of beta-adrenergic receptor activity?

<p>Devoid of beta-adrenergic receptor activity</p> Signup and view all the answers

What are the serious manifestations of decongestant toxicity?

<p>Seizures, dysrhythmias, cerebral haemorrhage, psychosis</p> Signup and view all the answers

What does the chronic overuse of imidazoline decongestants result in?

<p>Headache</p> Signup and view all the answers

What is the significant risk associated with phenylpropanolamine use, particularly among women?

<p>Haemorrhagic stroke</p> Signup and view all the answers

What is the most common cause of liver failure in the U.S.?

<p>Acetaminophen</p> Signup and view all the answers

What substance restores glutathione reserves by providing sulfhydric donors for the eventual detoxification of NAPQI?

<p>N-acetylcysteine</p> Signup and view all the answers

What does binding of NAPQI to hepatocyte membranes and sulfhydril proteins account for?

<p>Acetaminophen hepatotoxicity</p> Signup and view all the answers

What is the main reason for discontinuation of phenylpropanolamine (PPA) from pharmaceutical products?

<p>Risk of haemorrhagic stroke</p> Signup and view all the answers

What is the primary mechanism by which decongestants reduce nasal congestion?

<p>Stimulating the alpha-adrenergic receptor sites on vascular smooth muscles</p> Signup and view all the answers

What does chronic use or with large doses of acetaminophen lead to?

<p>Liver failure</p> Signup and view all the answers

What is the antidote for acetaminophen poisoning?

<p>N-acetylcysteine (NAC)</p> Signup and view all the answers

What is the most common cause of liver failure in the U.S.?

<p>Acetaminophen (N-acetyl-p-aminophenol, paracetamol)</p> Signup and view all the answers

What is the primary difference between ephedrine and pseudoephedrine in terms of adrenergic receptor activity?

<p>Ephedrine is a stimulant of both alpha and beta adrenergic receptors, while pseudoephedrine is a powerful alpha2-adrenergic receptor stimulant.</p> Signup and view all the answers

What does chronic overuse of imidazoline decongestants result in?

<p>Reactive vasodilation of the nasal mucosa</p> Signup and view all the answers

What is the significant risk associated with phenylpropanolamine use, particularly among women?

<p>Hypertension</p> Signup and view all the answers

What does binding of NAPQI to hepatocyte membranes and sulfhydril proteins account for?

<p>Hepatotoxic sequelae</p> Signup and view all the answers

What substance restores glutathione reserves by providing sulfhydric donors for the eventual detoxification of NAPQI?

<p>N-acetylcysteine (NAC)</p> Signup and view all the answers

What is the distinguishing feature of phenylpropanolamine in terms of beta-adrenergic receptor activity?

<p>It may result in reflex bradycardia</p> Signup and view all the answers

What are the common toxic manifestations of decongestant toxicity?

<p>CNS depression, hypotension, bradycardia, respiratory depression</p> Signup and view all the answers

What is the result of the production of the reactive intermediate, N-acetyl-p-benzoquinoneimine (NAPQI) metabolite?

<p>Hepatotoxic sequelae</p> Signup and view all the answers

What is recommended to effectively bind salicylates and to prevent intestinal obstruction due to concretions?

<p>Activated charcoal and cathartics</p> Signup and view all the answers

What is the primary mechanism by which decongestants reduce nasal congestion?

<p>Powerful alpha2-adrenergic receptor stimulation</p> Signup and view all the answers

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