Salts of Drugs a Health Risk

Many studies have shown that excess salt is harmful to heart health, but many commonly prescribed medicines have sodium added to improve their absorption into the body, but the effect of doing this has not been known. For example, 1 Alka-Seltzer tablet contains 324 mg of aspirin (the drug) and 445 mg of sodium.
University of Dundee and College of London researchers have found that a person taking the maximum, daily dose of some medicines would exceed the recommended daily dietary intake limits for sodium. In Australia, the total maximum recommended limit of sodium for adults should be less than 2300 mg per day (less for children). The label on the Alka-Seltzer tablets carries a warning that you should not take more than 8 tablets per day.
In the study, the researchers found that patients taking the sodium-containing medication had a 16% increased risk of a heart attack, were 7 times more likely to develop high blood pressure, and, were 28% more likely to die, compared with patients who took the non-sodium containing versions of the same drug.

So why do we add sodium to drugs if it is potentially harmful?

We do this because many drugs are actually insoluble in water. The cells in your body are made up mostly of water, so if you want to be able to transport a drug around the body, and have it absorbed into cells, it is beneficial if the drug is soluble in water.

How do we add sodium to drugs?

If the drug is, for example, a weak acid like aspirin, then it is not very soluble in water.
Being a weak acid, though, aspirin can undergo a proton transfer (neutralisation) reaction with a base such as sodium hydroxide. The product of a neutralisation reaction are salt and water.
acid + base → salt + water

aspirin + sodium hydroxide → sodium salt of aspirin + water

The sodium salt of aspirin readily dissolves in water by dissociating into positive sodium ions and negative "aspirin" ions.


Reference:
BMJ-British Medical Journal (2013, November 26). High salt levels in medicines increase risk of cardiovascular events. ScienceDaily. Retrieved November 28, 2013, from http://www.sciencedaily.com­ /releases/2013/11/131126191557.htm 

Further Reading
aspirin
mass conversions 
ppm
molarity
neutralisation
proton transfer reactions
acid dissociation constants

Suggested Study Questions: 

1. Convert these masses in milligrams to masses in grams
• 324 mg
• 445 mg
2. The label on the Alka-Seltzer packet recommends dissolving 2 tablets in water. For these two tablets, calculate the mass in milligrams of
• aspirin
• sodium
3. If you were to take the maximum number of tablets, 8, in a day, how much of each of the following substances would you be ingesting?
• aspirin
• sodium
4. Would you be exceeding the recommended daily dietary intake limits for sodium in Australia? Explain your answer.
5. A low salt food is one that contains less than 120 mg of sodium per 100 g of food. If Alka-Seltzer were to be considered a low salt food, what would the mass of each tablet need to be?
6. Aspirin has the molecular formula C₉H₈O₄. What is the molar mass of aspirin?
7. The sodium salt of aspirin has the molecular formula C₉H₇O₄^-Na⁺. What is the molar mass of the sodium salt of aspirin?
8. Calculate the mass of sodium in 1 Alka-Seltzer tablet due to the sodium salt of aspirin.
9. Compare the mass of sodium calculated above to the actual mass of sodium present in 1 Alka-Seltzer tablet according to the package. How would you explain the difference in the two masses?
10. If a person dissolved 2 Akla-Seltzer tablets in 150 mL of water, what is the concentration of sodium ions in the water in
    • mol/L
    • mg/L
    • ppm
11. Recommendations for the daily intake of potassium are higher than those for sodium at 4700 mg day, so one way to alleviate the sodium problem in aspirin tablets might be to replace the sodium with potassium. Describe one way that you could produce the potassium salt of aspirin.