CREST Silver award- detecting drugs

Introduction
Medicinal drugs, especially analgesics, have a wide range of uses such as
painkilling or helping with certain medical conditions such as haemophilia, a
blood clotting disorder that can be treated with aspirin. For our project, we
were tasked with researching DETECTING (imagine not detecting any otc
drugs L) OTC analgesic drugs. We decided to choose three drugs not containing
aspirin (ibuprofen, paracetamol, codeine), and 3 drugs containing aspirin
(anadin, buffex, genacote). We did some research into each of these drugs and
how they worked, as well as the possible side effects. We then did some
experiments on the drugs such as an experiment on how other ingredients
used alongside the main ingredient in these drugs influence the body, for
example caffeine being used alongside aspirin in some of the medications we
researched.

What we did
We considered a few different approaches to the project, but the one we
decided to choose was doing online research about experiments we couldn’t
do in school ourselves (such as detecting the presence of drugs in urine
samples) and also to gain some background knowledge on things like how each
OTC drug we chose to look at worked, but we also wanted to do some
experiments which we could do in school ourselves like titrating aspirin.

The list below is a list of all the things we completed during the project:

-Online research about opioids (codeine to be specific)

-Online research about paracetamol
-Online research about NSAIDS (ibuprofen, anadin, buffex, genacote)
-We sent out a survey asking people about their use of the drugs we
researched, as well as their use of medicinal drugs in general
-Online research about the presence of drugs in urine testing and other
methods used to detect the presence of drugs
-Reaction speed and heart rate test after consumption of caffeine
-Titrating aspirin

OTC analgesics we researched

For our science project, we have investigated a wide range of drugs and have
researched the mechanisms of action of the chosen substances. We have
chosen a total of six drugs, with all of them being OTC (over the counter). This
is due to the difficulty of obtaining drugs that are not OTC for legal reasons.
CREST Silver award- detecting drugs
Three of drugs we’ve chosen contain aspirin and three of them do not. The
following drugs that we chose to research are listed below:

Aspirin free drugs:

-Codeine (opioid)
-Paracetamol (non-opioid analgesic)
-Ibuprofen (NSAID)

Drugs containing aspirin:

-Anadin (NSAID)
-Buffex (NSAID)
-Genacote (NSAID

Chemical compositions:
Codeine: C18H21NO3
Paracetamol: WHERE IS MY BOI?
Ibuprofen: C13H18O2
Anadin: contains aspirin (C9H8O4), caffeine (C8H10N4O2) and paracetamol
(C8H10N4O2)
Buffex: contains aspirin (C9H8O4) and an antacid such as calcium carbonate
(CaCO3)
Genacote: contains aspirin (C9H8O4) which is then enteric coated, which means
that it dissolves in the small intestine rather than the stomach

Opioids explanation
Opioids are a type of drug that are mainly used for helping with pain but can
also be used as a cough suppressant or as an anti-diarrhoea drug. Opioids can
be effective anti-diarrheal drugs because they slow down the motility (the
ability of things to move around in the intestine) in the gastrointestinal tract.
The receptors that opioids bind to in the gut can reduce the activity of the
muscles that contract and move food and fluids through the digestive system.
By slowing down the movement of material through the gut, opioids reduce
the frequency and volume of bowel movements, which can help alleviate
diarrhoea. However, opioid-induced constipation is a common side effect of
using these drugs, and patients need to be monitored closely for any
gastrointestinal side effects. It is also important to consider that opioids are
not typically the first drug that would be used as treatment for diarrhoea due
to their ability to be abused and to cause things like dependence on the drug
and respiratory depression. Opioids are effective cough suppressants because
they act on the central nervous system to suppress the cough reflex. They can
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do this by binding to opioid receptors in the brain and spinal cord, which
reduces the activity of the cough reflex, acting as an agonist. Additionally,
opioids can cause sedation and a feeling of relaxation, which can also help to
reduce coughing. Because of this, some opioids such as codeine, morphine,
and hydrocodone are sometimes used as prescription cough suppressants for
severe or chronic coughs. Opioid drugs are a type drugs that can either be
synthesised in a lab or derived from the opium poppy plant (drugs that are
derived from the poppy plant are called opiates). Examples of opioid drugs
derived from opium poppies include morphine, codeine, and heroin. Some
opioid drugs are man-made and not derived from opium, such as fentanyl and
methadone. However, all opioids share a similar chemical structure and
interact with the body's opioid receptors to produce pain relief, euphoria, and
other effects. They work by binding to opioid receptors, which are located
throughout the brain and body. When an opioid binds to these receptors, they
activate a chain reaction of signals that inhibit activity of neurons that transmit
pain signals. When an opioid receptor is activated, it leads to the opening of
potassium channels. The opening of these channels leads to an increase in the
amount of potassium ions exiting the cell, which results in a decrease in the
membrane potential of the neuron. This decrease in membrane potential is
known as hyperpolarisation, which makes it more difficult to generate an
action potential and transmit pain signals, and as a result helps to relieve pain.

Codeine
Codeine is an opioid analgesic. It can be also used as a cough suppressant and
can be used as an anti-diarrhoeal drug. It works in a similar way to morphine
but is much weaker. The onset of action is thirty-sixty minutes, and the
duration is between four-six hours. Dosage (for an adult) will depend which
symptom you are taking the drug for. 120-240mg daily for pain relief; 45-
120mg daily (for suppressing coughs and 30-120mg daily for diarrhoea.
Codeine works directly on opioid receptors in the brain, rather than acting at
the pain of site like NSAIDs. It is an agonist of the MU opioid receptor (MOP)
which means that it binds to the receptor to produce a biological response.
When the pain signal is transmitted between opioid receptors through synaptic
transmission in the brain, codeine or morphine binds to the MU opioid
receptors leading to hyperpolarisation of the neuron which results in the
inhibition of nociceptive neurotransmitters and the pain signal is blocked. Due
to reduced neuronal excitability, this leads to an increased pain tolerance and
an analgesic effect. However, codeine must be activated by conversion to
morphine through a demethylation reaction mediated by the enzyme CYP2D6
to produce pain relief as codeine is inactive in humans. 10% of codeine is
CREST Silver award- detecting drugs
converted into morphine while 90% is converted into norcodeine, which is also
inactive although the amount converted will vary depending on such as factors
whether the person is an ultra or poor metaboliser.

How prostaglandins cause pain, inflammation and fever

Prostaglandins can cause pain by promoting inflammation, increasing
sensitivity to pain, and triggering muscle contractions or spasms in various
parts of the body. Prostaglandins are lipids that act locally, meaning that they
are produced in and act on specific cells or tissues in the body. Prostaglandins
are involved in many processes, including the inflammatory response, blood
clotting, and the regulation of blood pressure.
When prostaglandins are released, they can trigger the release of other
substances that promote inflammation, such as cytokines and histamine,
which can cause swelling, redness, and pain in the affected area.
Prostaglandins can also sensitise peripheral nerve endings to pain, making the
body more sensitive to painful stimuli.
In addition, prostaglandins can cause smooth muscle (muscle inside the body
that is not attached to a bone) to have spasms (the muscle repeatedly
involuntarily contracting), which can also contribute to pain.

Paracetamol
Paracetamol is a commonly encountered OTC painkiller and fever reducer. It is
used to treat mild to moderate pain such as headaches, muscle aches,
toothaches, and other types of pain. Paracetamol works by blocking the
production of prostaglandins, that cause pain and fever. In order to do this,
paracetamol inhibits the cyclooxygenase (COX) enzymes from working, and
these are responsible for the production of prostaglandins. Prostaglandins are
responsible for causing pain, inflammation and fever (see how prostaglandins
cause pain inflammation and fever paragraph for more information). By
blocking the production of these, paracetamol helps to reduce pain and fever
from occurring. However, one important feature of paracetamol is that it does
not have any anti-inflammatory effects, unlike other pain relievers such as
aspirin or ibuprofen. This means that it is not classified as an NSAID, despite
working in the same way. Is there a reason behind why it doesn’t produce
anti-inflammatory despite the mechanism of action being the same?

NSAID drugs
NSAID drugs work by inhibiting the production of prostaglandins by inhibiting
the COX enzyme. Prostaglandins are produced naturally in the body and
perform a variety of functions including causing pain, increasing inflammation
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and causing a fever. They cause inflammation by attracting white blood cells to
the site of an infection or injury by releasing inflammatory cytokines. In
response to there being a lot of white blood cells, the prostaglandins cause
blood vessel dilation to increase, leading to more blood flow to the affected
area. This increase in blood flow causes redness and warmth in the area of
injury or infection. Prostaglandins also increase the amount of substance that
can get through blood vessels (their permeability), allowing fluid and immune
cells to move from the bloodstream into the surrounding tissue, causing
swelling. By halting prostaglandin production, this helps to reduce these side
effects. NSAIDs prevents the production of prostaglandins by inhibiting the
enzyme cyclooxygenase (COX), which produces prostaglandins. This enzyme
comes in two forms: COX-1 and COX-2. COX-1 is present in most parts of the
body and creates prostaglandins that protect the stomach lining, help blood
flow to the kidneys normally, and help the blood to clot. On the other hand,
COX-2 is produced mainly at the site of an injury and is responsible for
producing prostaglandins that cause pain and inflammation.

Ibuprofen
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) mainly used to
help with mild to moderate pain and helping with a fever.

Anadin
Anadin is a non-steroidal anti-inflammatory drug (NSAID) mainly used to treat
mild to moderate pain such as headaches and period pains. It uses the active
ingredient of aspirin.

Buffex
Buffex is a non-steroidal anti-inflammatory drug (NSAID) mainly used to treat
heartburn and stomach ache. It uses the active ingredient of aspirin.

Genacote
Genacote is a non-steroidal anti-inflammatory drug (NSAID) mainly used to
treat mild to moderate pain and to lower the risk of a heart attack occurring in
patients with coronary artery disease. It uses the active ingredient of aspirin.

Drug use survey

As well as looking online as to how the drugs in our project are used, we also
wanted to put out a survey to see how people in our school used the drugs we
researched, as well as some other drugs, like caffeine. The survey asked if any
other drugs were also used for medicinal purposes (imagine using it
CREST Silver award- detecting drugs
recreationally), so that we could see if there were any other commonly used
drugs. This survey was anonymous, so we do not know the identities of who
answered and how factors such as age or gender impacted the results. We
held all participants at gunpoint, making sure they answered our questions
from the survey 
In question 1, we gave a list of the 6 drugs we researched (codeine,
paracetamol, ibuprofen, anadin, buffex, genacote) and asked people which of
the 6 analgesics they had taken before. Paracetamol was the most popular,
with ibuprofen being a close second.
In question 2, we asked people if they had taken any of the drugs above or
other common OTC drugs in the last year and what for. We found that one of
the most common drugs used was paracetamol, and it was mainly used to
treat stomach cramps such as period/menstrual cramps, as well as headaches
and other mild to moderate pain. Another drug from our list that was used was
ibuprofen, and this was used to treat a fever.
In question 3, we wanted to know more about the possible common side
effects from drugs, so we asked people what side effects they have
experienced from taking drugs. We found that, while most people did not
experience any side effects, a few people reported having drowsiness and
nausea, though this was not a common response to the question.
In question 4, we saw when researching drugs containing aspirin that caffeine
was often used alongside aspirin, so we wanted to see if it had any effect on its
own. We asked people how often they consume caffeine, which then linked to
the next question about caffeine withdrawal. Whilst most people who
answered our survey did not take any caffeine, a few people said that they had
caffeine a few times a week by drinking coffee and tea, and PRIME!!!!!
In question 5 we wanted to know about the side effects of caffeine withdrawal,
so we asked people if they have ever experienced caffeine withdrawal as well
as how they treated it. Since most of our participants did not take any caffeine,
most of them answered no. Those who did experience caffeine withdrawal said
that they experienced side effects such as severe headaches, tiredness and
mood swings. The most common way of treating this was by taking drugs such
as paracetamol.
In question 6, since we had researched drugs containing aspirin, we wanted to
know if any of our participants had taken any drugs containing aspirin. Whilst
most of our participants answered no, one person said that they have taken
them as blood clot preventers before.
In question 7, we wanted to find out what drug people used the most
frequently, so we asked which drug they have taken the most throughout their
lifetime. One drug that came up a lot was ibuprofen, and the primary use for it
CREST Silver award- detecting drugs
was to treat a fever. Paracetamol was also a very common answer, and it was
mainly used for treating mild to moderate pain such as headaches and
period/menstrual cramps, as well as treating fevers.
In the final question, we wanted to know if any people took a drug frequently
to treat a medical condition. Whilst most of our participants answered no, a
few people answered with yes and one person said that they used to but their
condition was later treated.

Caffeine speed reaction test

To investigate deeper on the ingredients used in aspirin-based medication
alongside the aspirin itself, we chose to experiment with the effects of
consuming caffeine which is an active ingredient in aspirin-based drugs such as
Anadin. To do this, we used caffeinated coke and measured the reaction times
of people before and 5 minutes after drinking the coke (Students 1-4). We
additionally measured the heartbeat of a second group of students before and
5 minutes after they drank the coke (Students A-B). One issue that we had to
solve was the fact that people expect that caffeine will make their reaction
times and heartbeat faster, and because of this, the results may change
because of the placebo effect and not because of the caffeine. We solved this
issue by giving some students a caffeinated and some students a non-
caffeinated version of the coke, and not telling the students which one they
got. This meant that they would not expect their reaction times to change, but
it also meant that we had a control group that we could compare our results to
who didn’t take the caffeine. We gave each student 20ml of the drink and
seeing as caffeinated regular coke (the one we used for the experiment)
contains 9.58mg per 100ml of coke, each student who got the caffeinated
version took 0.2mg of caffeine.

To have a good variation of results, we prepared 3 samples containing caffeine

and 3 not containing caffeine. We first carried out the reaction time
experiment, in which we first measured the students’ initial reaction times to
use as a baseline. We then gave the students 20ml of either a caffeinated or
non-caffeinated drink and waited for 5 minutes so the caffeine could take
effect. We repeated the measurements three times so that if one result was
anomalous, we could discard the result and use the other 2. In the second
group of students, in which we were measuring heart rate, we followed the
same procedure, but instead of measuring the reaction times, we measured
the heart rate, and we took only two measurements instead of three. The
results of our experiment are shown in the table below:
CREST Silver award- detecting drugs

Type of coke Reaction Heart Reaction Heart

consumed time before rate time after rate after
before
Studen Caffeinated 160 N/A 135 N/A
t1 160 100
110 125
Studen Non- 160 N/A 95 N/A
t2 caffeinated 120 100
100 105
Studen Caffeinated 180 N/A 170 N/A
t3 140 120
160 55
Studen Non- 180 N/A 90 N/A
t4 caffeinated 200 130
200 160
Studen Non- N/A 102 N/A 86
tA caffeinated 98 87
Studen Caffeinated N/A 88 N/A 96
tB 99 92

How drug urine tests work

In a drug urine test, the first thing that happens is that a person will be asked
to give a urine sample, which is then taken to a lab for testing. The sample is
then analysed in a variety of different ways such as immunoassays (using
antibodies to detect the presence of drugs) or gas chromatography-mass
spectrometry (separating the substances using chromatography, then using a
mass spectrometer machine to break down compounds, then measure their
mass and charge, which is then used to determine the chemical composition of
the unknown substance, to identify the presence of specific drug metabolites
(broken down or altered versions of the original drug taken). These start in the
blood but end up being excreted in your urine when the kidney filters the
blood.

Aspirin titration experiment

(Hi Kelly if you got this far, please send me the aspirin titration thingy when
you finish it so we can add it in, this is just a placeholder for now)