What Is Caffeine Poisoning?

Caffeine and aminophylline have similar pharmacological effects, but differ only in their strength. Sodium benzoate caffeine (Anna coffee) is a mixture of caffeine and sodium benzoate, containing 47% to 50% of anhydrous caffeine; aminophylline is a complex of theophylline and ethylenediamine. Caffeine poisoning is mostly caused by mistake Or caused by excessive treatment.

Basic Information

Visiting department

Emergency Department

Common causes

Caused by misuse or excessive treatment

Common symptoms

Nausea, vomiting, abdominal pain, headache, dizziness, tinnitus, irritability, delirium, etc.

Contagious

no

Causes of caffeine and aminophylline poisoning

Caffeine and aminophylline are both derivatives of xanthine. Caffeine poisoning is mostly caused by misuse or excessive treatment. A few are caused by ingestion of beverages containing a large amount of caffeine; occasionally infants and young children are highly sensitive to caffeine, and acute poisoning symptoms occur due to trace amounts entering the body. The effective therapeutic amount of aminophylline is not much different from the amount of poisoning. The poisoning can be caused by excessive oral administration, rectal administration, intramuscular injection, etc., too short intervals between medications, large intravenous doses, or rapid rates. Caused by the high sensitivity of the drug.

Clinical manifestations of caffeine and aminophylline poisoning

This class of drugs has: Exciting the central nervous system, diuresis and stimulating effects on the gastrointestinal tract; nausea, vomiting, abdominal pain, and even vomiting and blood in the stool may occur after poisoning; headache, dizziness, tinnitus, irritability, delirium, muscle tremor , Convulsions, coma, increased body temperature, increased breathing, tachycardia, and other arrhythmias; decreased blood pressure, increased urination, urgency, or hematuria.

Allergic reaction

Allergic reactions are mostly skin eczema, urticaria, or asthma, and there are polymorphic erythematous drug rashes. People with high allergies often experience sudden restlessness, loss of consciousness, cyanosis in the lips during bolus injection, and then stop breathing and heartbeat.

2. Overdose poisoning

Overdose poisoning is common in children who overdosed or accidentally took it, exceeding the maximum treatment amount (6mg / kg / time), with nausea, vomiting, restlessness in the early stage, and unconscious movements, thirst, dehydration, and low fever; vomiting in the later stage , Delirium, convulsions, coma, high fever, and collapse, also manifested as epilepsy-like seizures, which can die due to bulbar inhibition.

3. Individual differences

The cause of the side effects of aminophylline is related to the large differences in individual medications. Aminophylline clearance is slower in women than in men and older in younger people. Obesity, liver disease, heart failure, chronic obstructive pulmonary disease, hypoxemia, acidosis, and high-carb diets all affect aminophylline metabolism. Its half-life is prolonged, and it can also cause poisoning when it is used for a long time according to the conventional dose.

In addition, improper compatibility is also responsible for the side effects of aminophylline. Drugs that delay theophylline metabolism include erythromycin, spiramycin, and H ₂ -receptor antagonists. These drugs have the effect of reducing theophylline clearance and extending half-life. These drugs are used in combination with aminophylline and are prone to poisoning.

Excessive injection speed can also cause side effects of aminophylline. The exact cause of poisoning in the intravenous treatment dose is unknown, and it is believed to be related to the injection speed, so it is called "speed shock".

Caffeine and aminophylline poisoning treatment

Oral poisoning

If it is an internal poisoning, if there is no vomiting, induce vomiting immediately; and lavage the stomach with a 1: 5000 potassium permanganate solution or lukewarm water, and the cathartic salt is used for catharsis.

2. Overdose of aminophylline

If you take an overdose of aminophylline, you should immediately wash your intestines. Oral or inject an appropriate amount of activated carbon from the gastric tube to reduce the concentration of aminophylline. Intravenous infusion promotes excretion of toxicants, maintains body fluid balance, and appropriately adds potassium when urine is high.

3. Treatment with convulsions

If you have irritability or convulsions, you can use diazepam, chloral hydrate or short-acting barbiturates. The convulsive effect of phenobarbital sodium on aminophylline poisoning is better. If convulsions are caused by hypoxia caused by cerebral vasospasm caused by aminophylline, confirmed by fundus examination, atropine or anisodamine (654-2) can be selected. If continuous convulsions, persistent vomiting, and respiratory failure occur due to cerebral edema, dehydrating agents such as 20% mannitol and furosemide should be given. When central nervous system depression occurs, you can use stilpinine, nicotine rice and so on. Intravenous injection or intravenous infusion of pansentin for aminophylline poisoning has obvious effects on controlling heart rhythm disorders, preventing and treating disseminated intravascular coagulation.

4. Other

Treatments such as oxygen inhalation, cardiotonics, fever reduction, and infection prevention are important.