Treatment of Lethal Caffeine Overdose with Haemodialysis: A Case Report and Review

Gahona, Christian C Toquica; Bharadwaj, Ashwin K; Shah, Monarch; Bhagat, U.; Sterman, Paul; Vásquez, William F.

doi:10.2478/jccm-2022-0019

The Journal of Critical Care Medicine

2022

DOI: 10.2478/jccm-2022-0019

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Treatment of Lethal Caffeine Overdose with Haemodialysis: A Case Report and Review

Christian C Toquica Gahona

Ashwin K Bharadwaj

Monarch Shah

et al.

Abstract: Caffeine, chemically 1,3,7-trimethylxanthine, is the most widely consumed central nervous system stimulant in the world with pleiotropic effects on the cardiovascular, pulmonary, and renal systems. The advent of over the counter (OTC) caffeine formulations has opened the window for potential toxicity, either by inadvertent or intentional overdosing. We present the case of a patient who attempted suicide by caffeine overdose treated with emergent haemodialysis and a review of the literature.

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2024

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Cited by 3 publications

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Interaction of a caffeine overdose with clinical doses of contraceptive ethinyl estradiol in a young woman

Adachi,

Murata,

Inada

et al. 2024

Acute Medicine & Surgery

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AimThe overdose of caffeine, a cytochrome P450 1A2 probe, in young women has become a problem. The aim of this study was to evaluate possible drug interactions between intentionally overdosed caffeine (12 g) and oral contraceptive doses of ethinyl estradiol prescribed to a young woman in a suicide attempt.MethodsThe serum concentrations of caffeine in the patient and the time‐dependent ethinyl estradiol inhibition of caffeine oxidation in vitro were evaluated.ResultsThe serum concentration of caffeine 4 h after overdose was 136 μg/mL; from the data obtained between 4 and 28 h after overdose, the half‐life was estimated to be 33 h, which is many times larger than the normal value. Prescribed ethinyl estradiol prolonged caffeine elimination in vivo and inhibited paraxanthine formation, as evidenced by the low serum concentrations. In human liver microsomes, ethinyl estradiol (50 nM) inhibited half of caffeine N3‐demethylation. Pre‐incubation of human liver microsomes with ethinyl estradiol resulted in a powerful time‐dependent inhibitory effect on caffeine N3‐demethylation in human liver microsomes.ConclusionThese results suggest that a prescription history of contraceptives at clinical doses may have a strong effect on the pharmacokinetics of overdosed caffeine in young women, resulting in dangerous drug interactions.

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Interaction of a caffeine overdose with clinical doses of contraceptive ethinyl estradiol in a young woman

Adachi,

Murata,

Inada

et al. 2024

Acute Medicine & Surgery

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Simultaneous analysis of caffeine and paraxanthine provides potentially useful indexes in the treatment of acute caffeine intoxication

Yamazaki,

Kaizaki-Mitsumoto,

Sato

et al. 2024

J. Toxicol. Sci.

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Fatal poisoning by dietary supplements accompanied by massive rhabdomyolysis and multiple organ failure = Śmiertelne zatrucie suplementami diety przebiegające z masywną rabdomiolizą i niewydolnością wielonarządową

Fogiel,

Rak,

Picheta

et al. 2024

AMSIK

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Obesity epidemic and prevailing standards of desired body shape encourage society to use weight loss aids. Thermogenics, which are dietary supplements aimed at increasing energy expenditure, are particularly gaining popularity. These preparations can be easily purchased without prescription and have a complex composition, which means they can interact with numerous substances. The article describes the case of a 31-year-old female patient who, in a suicide attempt, ingested significant amounts of the dietary supplements ‘Blue Magic’ and ‘Purim’. Both supplements contain, among other ingredients: caffeine, yohimbine, reserpine, and synephrine. The patient developed multiple organ failure, which led to her death on the second day of hospitalization. Poisoning by dietary supplements, due to their diverse composition and the lack of correlation between the content and the composition declared by the manufacturer, can pose a significant threat to the health and life of consumers.

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Treatment of Lethal Caffeine Overdose with Haemodialysis: A Case Report and Review

Cited by 3 publications

References 42 publications

Interaction of a caffeine overdose with clinical doses of contraceptive ethinyl estradiol in a young woman

Interaction of a caffeine overdose with clinical doses of contraceptive ethinyl estradiol in a young woman

Simultaneous analysis of caffeine and paraxanthine provides potentially useful indexes in the treatment of acute caffeine intoxication

Fatal poisoning by dietary supplements accompanied by massive rhabdomyolysis and multiple organ failure = Śmiertelne zatrucie suplementami diety przebiegające z masywną rabdomiolizą i niewydolnością wielonarządową

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