Pharmacology Quiz on ASA and NSAIDs
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Questions and Answers

What is the most common toxicity associated with the use of ASA?

  • Fluid retention
  • Gastric irritation (correct)
  • Liver injury
  • Skin rash

Which of the following is a primary reason why acetaminophen is preferred over ASA for children?

  • It is less effective as an analgesic.
  • It does not cause gastric irritation. (correct)
  • It is only available in liquid form.
  • It has a higher risk of overdose.

Which mechanism is primarily involved in the action of NSAIDs like ibuprofen?

  • Inhibiting cytokine release
  • Enhancing platelet aggregation
  • Promoting the synthesis of prostaglandins
  • Blocking the conversion of arachidonic acid (correct)

What adverse effect is less likely to occur with NSAIDs compared to ASA?

<p>Gastric irritation (C)</p> Signup and view all the answers

What is the primary mechanism by which antihistamines alleviate allergy symptoms?

<p>They block histamine receptors to prevent histamine binding. (C)</p> Signup and view all the answers

How can acetaminophen inadvertently lead to overdose?

<p>It is often combined with other medications. (A)</p> Signup and view all the answers

Which class of drugs is considered more effective than antacids in reducing stomach acid secretion?

<p>Proton Pump Inhibitors (PPIs) (B), Hâ‚‚ Receptor Antagonists (D)</p> Signup and view all the answers

Which class of drugs primarily promotes the formation of protective prostaglandins?

<p>COX-1 enzymes (B)</p> Signup and view all the answers

What is a common adverse effect of Hâ‚‚ receptor antagonists?

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

Which of the following drugs would likely not lead to significant central nervous system effects?

<p>Hâ‚‚ Receptor Antagonists (A), Second generation antihistamines (B), Antacids (C)</p> Signup and view all the answers

What is a significant risk factor for liver injury due to acetaminophen overdose?

<p>Alcohol use disorder (B)</p> Signup and view all the answers

What condition can be a result of chronic high-dose ASA intake?

<p>Gastric irritation and increased bleeding (C)</p> Signup and view all the answers

What is the main purpose of antacids?

<p>To neutralize gastric acid and maintain stomach pH. (B)</p> Signup and view all the answers

Which drug class permanently inhibits acid secretion in the stomach?

<p>Proton Pump Inhibitors (PPIs) (B)</p> Signup and view all the answers

What effect do decongestants have on blood vessels in the nasal passages?

<p>They constrict blood vessels, reducing fluid leakage. (C)</p> Signup and view all the answers

What is a potential consequence of long-term use of decongestants?

<p>Increased nasal congestion over time. (A)</p> Signup and view all the answers

What is the primary purpose of over-the-counter (OTC) drugs?

<p>To allow the public to self-diagnose and treat mild symptoms. (A)</p> Signup and view all the answers

Which of the following best describes a guideline for the use of OTC drugs?

<p>Adverse effects should prompt immediate cessation of the drug. (C)</p> Signup and view all the answers

What is a requirement for new OTC drugs before they can be sold?

<p>They must undergo rigorous preclinical testing for safety. (A)</p> Signup and view all the answers

Which statement is true regarding the best selection of OTC drugs?

<p>The best OTC drug has a known level of toxicity and proves efficacy for the condition. (A)</p> Signup and view all the answers

What classification does acetylsalicylic acid fall under?

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

Which factor is NOT a part of the control over OTC drugs as per the relevant regulations?

<p>Sales volume metrics. (D)</p> Signup and view all the answers

How should OTC products be approached when considering their use?

<p>Caution is needed due to potential toxicity and interactions. (C)</p> Signup and view all the answers

What is a specified limitation for self-medication with OTC products?

<p>Self-medication should not exceed two weeks without consulting a physician. (D)</p> Signup and view all the answers

What is a common allergic reaction associated with the food color tartrazine?

<p>Allergy to aspirin (D)</p> Signup and view all the answers

Why is sodium nitrate controversial in the food industry?

<p>It can produce carcinogenic nitrosamines (C)</p> Signup and view all the answers

What is one of the primary functions of antioxidants in food additives?

<p>To prevent rancidity and discoloration (D)</p> Signup and view all the answers

Which food additive has been shown to cause tightening of muscles, particularly in the face and neck?

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

What method has been traditionally used in food preservation that also carries a small carcinogenic risk?

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

What is the maximum number of food colors permitted for use in Canada?

<p>10 (C)</p> Signup and view all the answers

What is the primary purpose of texture agents in food products?

<p>To improve or give a specific texture (C)</p> Signup and view all the answers

Why are antibiotics banned in Canada within the context of food additives?

<p>They contribute to antibiotic resistance (C)</p> Signup and view all the answers

What is the primary purpose of chemical sunscreens?

<p>To absorb UV radiation before it penetrates the skin. (D)</p> Signup and view all the answers

Which statement is true about herbal medicines compared to allopathic medicine?

<p>Herbal medicines are often unpurified and lack extensive testing. (B)</p> Signup and view all the answers

What is a significant risk associated with the use of antacids in drug absorption?

<p>They can alter the pH of stomach acid, affecting drug absorption. (A)</p> Signup and view all the answers

What distinguishes phytopharmaceuticals from herbal medicines?

<p>Phytopharmaceuticals include evidence of efficacy and documented toxicity. (D)</p> Signup and view all the answers

What has contributed to the growing popularity of herbal drugs among the general public?

<p>They are believed to have fewer side effects compared to synthetic drugs. (C)</p> Signup and view all the answers

Which is a characteristic of allopathic phytopharmaceuticals?

<p>They have full status as drugs and meet all Drug requirements. (A)</p> Signup and view all the answers

Why do many herbal drugs lack sufficient safety and efficacy data?

<p>Few have undergone randomized control trials. (B)</p> Signup and view all the answers

What is a major concern regarding herbal drug manufacturers and retailers?

<p>They often promote herbal products for their financial gain. (D)</p> Signup and view all the answers

What must a manufacturer do if an additive is not listed in the List of Permitted Food Additives?

<p>Provide information on proposed use, evidence of safety, and efficacy. (B)</p> Signup and view all the answers

How is the acceptable human dose of an additive determined based on animal studies?

<p>It is calculated as either 1/100 or 1/1000 of the highest no-effect dose in animals. (A)</p> Signup and view all the answers

Why might toxicity estimates from animal studies overestimate actual human risk?

<p>Studies typically last only a couple of years while humans can be exposed their entire lives. (C)</p> Signup and view all the answers

What typically happens to food additives that test positive for carcinogenicity?

<p>They usually are not permitted to be used as food additives. (A)</p> Signup and view all the answers

Under what conditions is the use of food additives considered justified?

<p>To maintain or enhance the quality or acceptability of food. (A)</p> Signup and view all the answers

What has contributed to public mistrust regarding food additives?

<p>Concerns about hyperactivity related to some food colours and preservatives. (A)</p> Signup and view all the answers

What is one example of a food additive that has been prohibited due to its toxic effects?

<p>Cobalt chloride. (A)</p> Signup and view all the answers

Which class of food additives is described as being prevalent in foods?

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

Flashcards

What are antihistamines?

Antihistamines are drugs used to treat allergy symptoms by blocking histamine receptors, which are involved in the release of histamine, a substance released during allergies. They come in two generations: first generation, causing drowsiness, and second generation, less sedating.

How do antacids work?

Antacids neutralize stomach acid by chemical reactions, maintaining a pH of 4 in the stomach. Systemic antacids are absorbed by the GI tract, while non-systemic ones are not absorbed and coat the stomach lining.

What are H2 receptor antagonists?

H2 receptor antagonists block histamine receptors involved in acid secretion, reducing acid production. They are more effective than antacids and have fewer adverse effects.

How do PPIs work?

Proton pump inhibitors (PPIs) permanently bind to the proton pump, reducing acid secretion by at least 90%. They are the most effective and have low adverse effects.

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What are decongestants and how do they work?

Decongestants reduce nasal congestion by constricting blood vessels in the nasal passages, thereby reducing fluid leakage. Phenylephrine and pseudophedrine are common decongestants.

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Why do first-generation antihistamines cause drowsiness?

First-generation antihistamines are known for their sedative effects. They cause drowsiness because they can cross the blood-brain barrier and affect the central nervous system.

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Why are second-generation antihistamines preferred?

Second-generation antihistamines are generally less sedating than first-generation ones. They are preferred because they are more targeted and have fewer effects on the central nervous system.

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What are the downsides of long-term decongestant use?

Long-term use of decongestants can lead to local irritation and chronic congestion. This is because the body can become accustomed to the constricted vessels, leading to rebound congestion.

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Over-the-Counter Drugs

Drugs that can be bought without a prescription, typically for treating mild symptoms.

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Prescription Drugs

Drugs that are only available with a prescription from a healthcare professional.

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OTC Drug Guidelines

The use of over-the-counter (OTC) drugs should be limited to mild symptoms and should not replace professional medical care.

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Self-Medication

The process of using medications without a doctor's direction, which can be risky.

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Food and Drugs Act

Regulations that ensure the safety, effectiveness, and correct labeling of over-the-counter drugs.

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Analgesics

Drugs used to reduce pain, often found in over-the-counter remedies.

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Acetylsalicylic Acid

A common analgesic found in Aspirin, which helps reduce pain, fever, and inflammation.

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Prostaglandins

Chemical messengers that play a role in pain and inflammation.

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What are internal analgesics?

Internal analgesics are medications used to relieve pain, reduce fever, and in some cases, reduce inflammation within the body. They work by interfering with the production of prostaglandins, which are chemicals involved in pain, fever, and inflammation.

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What is Aspirin (ASA)?

Aspirin (ASA) is a commonly used internal analgesic with a wide range of applications, including pain relief, fever reduction, and prevention of blood clots. While effective, it can cause gastric irritation, especially with long-term high doses.

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What's Acetaminophen (Tylenol)?

Acetaminophen (Tylenol) is a popular over-the-counter analgesic that works by inhibiting prostaglandin synthesis without causing gastric irritation like aspirin. However, overuse can lead to severe liver damage.

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What are NSAIDs?

Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Advil) and naproxen (Aleve), are effective at relieving pain, reducing fever, and suppressing inflammation. While safer than aspirin, they still can cause gastric irritation and other side effects.

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What are prostaglandins?

Prostaglandins are a group of hormone-like substances, some of which contribute to pain, inflammation, and fever. Their production is influenced by enzymes called prostaglandin synthases.

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How do internal analgesics work?

Internal analgesics act by inhibiting prostaglandin synthases, the enzymes responsible for producing prostaglandins. This reduces pain, fever, and inflammation by decreasing the availability of these signaling molecules.

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What are COX-1 and COX-2?

COX-1 and COX-2 are two types of enzymes that convert arachidonic acid into different prostaglandins. COX-1 produces those that protect the stomach, while COX-2 produces inflammatory ones. Internal analgesics often block both, leading to both beneficial and adverse effects.

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Why does blocking COX-2 have a different effect than blocking COX-1?

Blocking COX-2 is beneficial as it reduces inflammation, while blocking COX-1 can lead to unwanted side effects like stomach irritation. This is why some analgesics are tailored to specifically inhibit COX-2.

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List of Permitted Food Additives

A list published by Health Canada containing all permitted food additives and their approved uses.

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Toxicity Evaluation of Food Additives

The process of determining if a food additive is safe for consumption by evaluating its potential risks and benefits to human health.

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No-Effect Dose

The highest dose of a substance that does not produce any adverse effects in animals.

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Rational Use of Food Additives

The practice of using a food additive only when it is necessary to enhance or maintain the quality or acceptability of the food.

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Flavoring Additives

A class of food additives that contributes to the flavor of food.

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Naturally Occurring Carcinogen

A food additive that is naturally found in food but can still be harmful to health.

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Carcinogenicity Testing

The assessment of a food additive's potential to cause cancer in humans.

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Special Groups (Food Additives)

A group of people who may be more sensitive to certain food additives due to their lifestyle or health conditions.

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What are over-the-counter drugs?

These drugs are sold without a prescription and are typically used for treating mild symptoms. They are available over the counter in pharmacies and grocery stores.

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How do chemical sunscreens work?

These drugs contain compounds that directly absorb UV radiation before it can penetrate the skin. They include chemical filters like oxybenzone, avobenzone, and octinoxate.

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What are phytopharmaceuticals?

These drugs are obtained from plants and have a proven therapeutic effect with documented toxicity. They are purified and used in specific doses.

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What are herbal drugs?

They are plant-based products sold to treat various health conditions but lack a Drug Identification Number (DIN). They often lack extensive clinical trial data and purity.

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How do physical sunscreens work?

These products contain minerals like zinc oxide and titanium dioxide. They physically block and scatter UV rays, preventing their penetration into deeper skin layers.

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What is the value of plants in medicine?

Drugs derived from natural sources, whether plant, animal, or mineral origin, are often used directly or modified into semi-synthetic forms for enhanced effects.

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What are physical sunscreens?

They contain minerals that physically block and scatter UV rays. They offer broader protection than chemical sunscreens but can leave a white cast on the skin.

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What are chemical sunscreens?

They contain compounds that absorb UV radiation before it can penetrate the skin. They are lighter on the skin but may offer less broad protection.

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What are flavoring agents?

Flavoring agents that enhance the taste of food, not for nutrition, and are widely used in various food types. Examples include MSG, smoke essence, and synthetic flavors.

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What is MSG?

A type of flavor enhancer commonly used in food, known for intensifying umami taste. However, excessive consumption can cause side effects such as headaches and nausea.

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What are food colors?

Organic dyes used in food to give it a more appealing color. While some are well-tolerated, certain individuals may exhibit allergic reactions, particularly to tartrazine.

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What are texture agents?

Substances added to improve or modify the texture of a food product. Examples include silicates that keep flour free-flowing and emulsifiers used in ice cream.

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What are preservatives?

Substances used primarily to prolong the shelf life of food by inhibiting bacterial growth. These are essential for preventing spoilage and enabling food transport.

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What is sodium nitrate?

A type of preservative that helps preserve meats by preventing bacterial growth and imparting a red color. However, their use is debated due to potential health concerns related to nitrosamines.

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What are antioxidants?

Substances that prevent food from degrading due to oxidation. They preserve the taste and appearance of food by preventing rancidity and discoloration.

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What are antibacterial additives?

Substances added to food to inhibit the growth of microorganisms, preserving its quality. Examples include antibiotics, though their use is regulated due to the risk of promoting antibiotic resistance.

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Study Notes

Prescription Drugs

  • Prescription drugs are restricted to sale by prescription only.

Non-Prescription Drugs

  • Non-prescription (OTC) drugs can be sold to the general public without a prescription.
  • These drugs are sold on the premise that the public is able to diagnose mild symptoms and select appropriate treatment.

Guidelines for Using OTC Drugs

  • OTC drugs are not a replacement for prescription drugs or professional care.
  • Only use when symptoms are mild.
  • Consult a physician for serious symptoms or worsening conditions.
  • Stop using the drug immediately if adverse effects occur.
  • OTCs can have serious consequences, including drug interactions and toxicities.
  • If unsure, consult a pharmacist.
  • Self-medication should not exceed two weeks without consulting a physician.

Safety and Efficacy of OTC Drugs

  • The sale of OTCs is controlled by the Food and Drugs Act.
  • This act controls safety, efficacy, advertising, and sale of OTCs.
  • New OTCs undergo pre-clinical testing for safety.
  • Post-market safety surveillance is also conducted on OTCs.
  • Some prescription drugs become OTCs after extensive clinical trials.

Selection of Appropriate OTC Drugs

  • The best OTC drug for a condition will have proven efficacy and low toxicity.
  • Simpler formulations (single ingredient) are generally preferred.
  • Generics are usually cheaper and equally effective as brand name products.
  • Dosage forms and active ingredient dosages should be appropriate.

Common OTC Drugs

  • Internal Analgesics
    • Acetylsalicylic Acid (Aspirin): Relieves pain, fever, and inflammation by inhibiting prostaglandin synthesis. Low doses can prevent stroke and heart attack. Common toxicity is gastric irritation.
    • Acetaminophen (Tylenol): Effective analgesic and antipyretic, equally to ASA, but does not cause gastric irritation. Overdose can lead to fatal liver injury.
    • NSAIDs (Ibuprofen, Naproxen): Effective analgesic, anti-inflammatory. Gastric irritation is less common than with Aspirin, but other side effects are possible.
  • Antihistamines
    • Prevent the binding of histamine to receptors, thus decreasing allergic symptoms.
    • First-generation antihistamines cause sedation.
    • Second-generation antihistamines are less sedating.
  • Drugs for Excess Stomach Acid (Antacids)
    • Neutralize stomach acid through acid-base reactions
    • Systemically absorbed or are non-systemic
  • Hâ‚‚ Receptor Antagonists
    • Block Hâ‚‚ receptors reducing stomach acid production.
  • Proton Pump Inhibitors (PPIs)
    • Permanently bind to the proton pump, inhibiting acid secretion by almost 90%.
  • Decongestants
    • Cause constriction of small blood vessels to reduce nasal congestion.
  • Cough Suppressants
    • Centrally acting (codeine, dextromethorphan): Blocks the processing of cough information in the brain.
    • Peripherally acting: Blocks nerve endings to inhibit the cough reflex.
  • Sleep Aids
    • Example: Melatonin, is intended to help people fall asleep, or to relieve sleepiness.
  • Laxatives
    • Stimulant laxatives increase the activity of the intestine and secretion.
    • Bulk-forming and osmotic laxatives draw water into the stool, making it softer.
  • Antidiarrheal Agents
    • Control diarrhea by absorbing certain substances or
    • constraining the intestines.
  • Vitamins
    • Vitamins should be obtained from an outside source (excludes Vitamin D and K which the body does produce).
    • Water-soluble vitamins include C and B vitamins.
    • Fat-soluble vitamins include A, D, E, K.
    • Specific uses and deficiency symptoms are discussed in later notes.
  • Herbal Drugs
    • Herbal drugs are derived from plants and are used to treat illnesses or improve health.
    • Herbalists, the individuals practicing herbal medicine will sometimes give conflicting information with modern medicine. -Herbal drugs are widely used and many are gaining popularity due to the belief that natural products are generally safer.
    • There are concerns that herbal products can be adulterated or contain substances other than what they may claim to contain (e.g., harmful toxins).
    • Herbal drugs, like many drugs can have interactions with other drugs or conditions (e.g., allergies, or existing health conditions like kidney damage).

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Description

Test your knowledge on the common toxicities and the effects of ASA, acetaminophen, and NSAIDs in this pharmacology quiz. Explore the differences in mechanisms, adverse effects, and treatments related to pain relief and allergy symptoms. Perfect for healthcare students and professionals alike.

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