Caffeine Effects, Overdose and Episode 262

Caffeine Effect and Overdose
with Lisa Booze, PharmD, CSPI
Maryland Poison Center (MDPoison.com)
Do you drink coffee, tea or cola sodas? The vast majority of us do and in some cases, maybe for most of us, the caffeine content is the main reason for drinking them. In moderation, caffeine is safe. But most people don’t realize that caffeine can be quite toxic in large doses.
We all know that caffeine is a stimulant, producing alertness, restlessness and hyperactivity, but it’s also a cardiovascular stimulant, causing tachycardia and an increase in blood pressure. The most common symptoms following the ingestion of large doses are nausea and vomiting, which can be severe and protracted. Caffeine is a diuretic so consuming large amounts can lead to dehydration. With very large doses, more serious effects can occur, including dysrhythmias such as supraventricular tachycardia, atrial fibrillation, and ventricular tachycardia, seizures, metabolic acidosis, low potassium levels and cardiovascular collapse. These serious effects can occur with overdoses of more than 1000 mg in an adult, or 40 mg/kg in a small child. The lethal dose of caffeine is 150-200 mg/kg in an adult.
Here is the caffeine content of  some foods, drinks and medications that are part of our daily lives. The amount of caffeine in a brewed or instant cup of coffee can be anywhere between 50 and 180 mg. Tea contains 20-90 mg per 5 oz cup, and a 12 oz can of a cola soft drink has 30-50 mg caffeine. Over –the- counter stimulants like No Doz® and Vivarin® contain 100 to 200 mg caffeine per tablet. For adults, the toxic dose would be equivalent to more than 10 cups of coffee or 5-10 tablets of an over-the-counter stimulant. Other OTC’s that contain smaller doses of caffeine, usually around 32 to 65 mg, include some Anacin® and Excedrin® formulations and Midol®. There are also many dietary supplements sold in stores that contain caffeine and herbal stimulants in various concentrations. These supplements ...

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