Module 5

Question 1

What defines an over-the-counter (OTC) drug?

Answer 1

A drug sold without a prescription for mild, self-diagnosable conditions.

Question 2

What are key guidelines for safe OTC use?

Answer 2

Use for mild symptoms only, stop if adverse effects occur, don’t exceed 2 weeks, and consult a pharmacist if unsure.

Question 3

Which law regulates OTC drug safety in Canada?

Answer 3

The Food and Drugs Act.

Question 4

What is “grandparenting” in drug approval?

Answer 4

When older OTC drugs (e.g., acetaminophen) remain on the market without new RCT testing.

Question 5

What are the main internal analgesics?

Answer 5

ASA (Aspirin), Acetaminophen (Tylenol), and NSAIDs (Ibuprofen, Naproxen).

Question 6

How does ASA work?

Answer 6

Inhibits prostaglandin synthesis → reduces pain, fever, inflammation; prevents platelet aggregation

Question 7

What are ASA’s main toxicities?

Answer 7

Gastric irritation, tinnitus, Reye’s syndrome in children, rare allergies.

Question 8

How does acetaminophen differ from ASA?

Answer 8

Same pain/fever relief but no anti-inflammatory effect and safer for stomach; overdose causes liver toxicity.

Question 9

What are NSAIDs used for and what are their risks?

Answer 9

Pain, inflammation, fever; can cause gastric irritation, dizziness, fluid retention.

Question 10

Which internal analgesic is safest for children with fever?

Answer 10

Acetaminophen (not associated with Reye’s syndrome).

Question 11

Difference between 1st and 2nd generation antihistamines?

Answer 11

1st gen (diphenhydramine) cause sedation; 2nd gen (cetirizine, loratadine) are less sedating.

Question 11

What’s the mechanism of antihistamines?

Answer 11

Block H₁ histamine receptors → reduce allergy symptoms.

Question 12

What are the three main drug classes for excess stomach acid?

Answer 12

Antacids, H₂ receptor antagonists, and proton pump inhibitors (PPIs).

Question 13

Example of an H₂ antagonist and its action?

Answer 13

Ranitidine – blocks histamine receptors to reduce acid secretion.

Question 14

Example of a proton pump inhibitor and its action?

Answer 14

Omeprazole – permanently binds to proton pumps to block acid production.

Question 15

What’s a common decongestant and its caution?

Answer 15

Pseudoephedrine or phenylephrine; don’t use >3 days to avoid rebound congestion.

Question 16

Which cough suppressant is preferred over codeine?

Answer 16

Dextromethorphan (non-addictive).

Question 17

What is melatonin used for?

Answer 17

Jet lag and shift-work sleep adjustment.

Question 18

What are common types of laxatives?

Answer 18

Stimulant (bisacodyl), bulk-forming (methylcellulose), osmotic (PEG 3350).

Question 19

What is the drug of choice for traveller’s diarrhea?

Answer 19

Loperamide

Question 20

What OTC cream treats mild inflammatory skin reactions?

Answer 20

0.5%–1% Hydrocortisone cream.

Question 21

What are common side effects of iron supplements?

Answer 21

Nausea, vomiting, diarrhea, constipation, dark stools.

Question 21

Which OTC drugs can interact with other drugs?

Answer 21

ASA (↑ bleeding with anticoagulants), antacids (reduce absorption of some drugs), antihistamines (↑ sedation with alcohol).

Question 22

What are herbal drugs?

Answer 22

Plants or plant parts used to prevent or treat illness or promote health.

Question 23

Why are herbals so popular?

Answer 23

Seen as “natural” and marketed as safe alternatives.

Question 24

What are four classifications of medicinal/herbal products?

Answer 24

Allopathic medicine herbal medicine phytopharmaceuticals allopathic phytopharmaceuticals

Question 25

What are the main problems with herbal drugs?

Answer 25

Lack of testing, inconsistent standardization, possible adulteration, and drug interactions.

Question 26

Example of adulteration in herbals?

Answer 26

Addition of hidden drugs like NSAIDs or Viagra to increase potency.

Question 27

What are common toxicities of St. John’s Wort?

Answer 27

Phototoxicity, serotonin syndrome, drug interactions.

Question 28

What is aloe vera used for and what’s its risk?

Answer 28

Burns and wound healing (topical); oral ingestion → severe diarrhea.

Question 29

What is devil’s claw used for?

Answer 29

Osteoarthritis and back pain; may cause diarrhea.

Question 30

What is panax ginseng used for?

Answer 30

Energy, memory, immunity; can raise blood pressure and insulin.

Question 31

What is echinacea used for?

Answer 31

Common cold prevention; avoid in autoimmune disorders.

Question 32

What is valerian used for?

Answer 32

Mild insomnia and anxiety; may cause sedation and liver toxicity.

Question 33

How can herbal safety be improved?

Answer 33

Require purity standards, RCT testing, toxicity studies, and comparison to allopathic drugs.

Question 34

What are the two vitamin categories?

Answer 34

Water-soluble (C, B-complex) and fat-soluble (A, D, E, K).

Question 35

What defines a vitamin?

Answer 35

Essential organic compound needed for metabolism, not synthesized by the body (except D & K).

Question 36

When are vitamin supplements necessary?

Answer 36

Growth, pregnancy, illness, stress, absorption disorders, or poor diet.

Question 37

Function of Vitamin A?

Answer 37

Vision (rhodopsin), epithelial tissue maintenance, growth. Deficiency: night blindness, dry skin. Toxicity: enlarged liver, headache, vomiting.

Question 37

What is the difference between nutritional and megavitamin approaches?

Answer 37

Nutritional = meeting RDA; Megavitamin = excessive intake (can cause toxicity).

Question 37

Function of Vitamin D?

Answer 37

Absorbs calcium/phosphate, supports bone growth. Deficiency: rickets, osteomalacia. Toxicity: high blood calcium → organ calcification.

Question 38

Function of Vitamin E?

Answer 38

ntioxidant, protects cells and RBCs. Deficiency: rare; seen in malabsorption disorders. Toxicity: interferes with Vitamin K and blood clotting.

Question 39

Function of Vitamin B12?

Answer 39

RBC and nerve function. Deficiency: anemia, nerve damage.

Question 40

Function of Folic Acid?

Answer 40

DNA synthesis, prevents neural tube defects. Deficiency: anemia, birth defects.

Question 41

Function of Vitamin C?

Answer 41

Collagen formation, antioxidant. Deficiency: scurvy (bleeding gums, poor healing). Toxicity: diarrhea, kidney stones.

Question 41

What are food additives?

Answer 41

Substances added to food to improve appearance, flavor, texture, storage, or nutrition.

Question 42

What are the two types of additives?

Answer 42

Intentional (added deliberately) and unintentional (contaminants).

Question 43

Who regulates food additives in Canada?

Answer 43

Health Canada under the Food and Drugs Act.

Question 44

What is the “no-effect dose”?

Answer 44

The highest dose with no observed adverse effects in animals; human acceptable dose = 1/100–1/1000 of that.

Question 45

WHO’s three criteria for acceptable additives?

Answer 45

Must enhance food quality, be pure, and be used in minimal effective amounts.

Question 46

Example of flavouring agent and risk?

Answer 46

MSG – can cause headaches and nausea (“Chinese restaurant syndrome”).

Question 46

Example of texturing agent?

Answer 46

Silicates, agar, gums – used to thicken or maintain texture.

Question 46

Example of colouring agent and risk?

Answer 46

Tartrazine – can cause allergic reactions.

Question 47

Example of preservative and risk?

Answer 47

Sodium nitrite – may form carcinogenic nitrosamines.

Question 48

Example of antioxidant additives?

Answer 48

Ascorbic acid (vitamin C) and tocopherols (vitamin E).

Question 49

Example of sweetener and caution?

Answer 49

Aspartame – unsafe for people with phenylketonuria (PKU).

Question 50

Which vitamins can build up to toxic levels?

Answer 50

Fat-soluble (A, D, E, K).

Question 51

Why are food additives highly regulated?

Answer 51

Everyone consumes them unknowingly; they must be proven safe at approved doses.