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|Example of Acute Exposure data from MEDITEXT.|
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Example Content from MEDITEXT for Caffeine:
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ACUTE EXPOSURE INFORMATION
- USES: Caffeine (1,3,7-trimethylxanthine) is present in coffee, tea, colas, and chocolate. It is also utilized in over-the-counter cough and cold therapies, and in many dietary supplement products used as anorexiants, diuretics, and stimulants. Botanical sources of caffeine include: guarana, yerba mate, and kola nuts. Caffeine is used medicinally for neonatal apnea and postlumbar puncture headache.
- PHARMACOLOGY: Caffeine is a trimethylxanthine closely related to theophylline. It acts through nonselective inhibition of adenosine receptors and phosphodiesterase. There is also beta-1 and beta-2 adrenergic stimulation secondary to catecholamine release.
- TOXICOLOGY: Caffeine is an adenosine analog and functions primarily as an adenosine antagonist lowering the seizure threshold. It also inhibits phosphodiesterase, resulting in accumulation of cAMP and calcium, causing organ-specific downstream effects such as smooth muscle relaxation, or muscle/cardiac/CNS excitation. Caffeine overdoses result in surges in circulating catecholamines and rennin, as well as increased levels of norepinephrine, dopamine, and serotonin in the brain.
- EPIDEMIOLOGY: Caffeine is commonly used; however, severe manifestations of toxicity are rare, and most exposures result in mild toxicity.
- WITH POISONING/EXPOSURE
- MILD TO MODERATE TOXICITY: The earliest symptoms of acute caffeine poisoning include: anorexia, tremor, and restlessness, followed by nausea, vomiting and tachycardia. Chronic high-dose caffeine intake can lead to "caffeinism" which includes nervousness, twitching, anxiety, tremulousness, insomnia, palpitations, and hyperreflexia.
- SEVERE TOXICITY: With serious ingestions hypokalemia, hyperglycemia, metabolic acidosis, rhabdomyolysis, hypotension, confusion, seizures, tachycardia, and nonfatal dysrhythmias may occur.
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