caffeine

Caffeine citrate is a commonly prescribed drug in preterm neonates. The direct effect of caffeine citrate on the activation of diaphragmatic motion has not been extensively researched.

This observational study aimed to assess the changes in electrical activity of the diaphragm in response to caffeine citrate administration and discontinuation in preterm neonates.

Preterm infants [< 34 weeks’ gestational age (GA)] admitted to a level-IV neonatal intensive care unit in South Korea supported by invasive or non-invasive neurally adjusted ventilatory assist with caffeine citrate administration were prospectively enrolled in this observational study. The electrical activities of the diaphragm (Edi), Edi peak and Edi min values, before and after administering the loading and initial maintenance doses of caffeine citrate, and before and up to 48 hours after discontinuation, were analyzed.

Thirteen infants with a GA and birthweight of 28.8 ± 2.1 weeks and 1231 ± 441 g, respectively, were included. Edi peak and Edi min tended to increase when the neural respiration rate was ≥ 30 breaths/min. Edi peak and Edi min showed a higher trend after caffeine citrate loading and maintenance dose administration, particularly in infants born at < 28 weeks of GA or with a birthweight of < 1250 g, compared with those born at ≥ 28 weeks of GA or with a birthweight ≥ 1250 g. Caffeine citrate discontinuation resulted in an increased number of episodes of apnea and desaturation.

Changes in Edi peak and Edi min showed different trends depending on perinatal factors. On caffeine citrate cessation, monitoring changes in clinical symptoms in near-term post-menstrual age may be prudent.

Ergotamine is a very common antimigraine and is widely used in the management of headaches such as cluster and acute migraines. However, Ergotamine poisoning is an infrequent condition, and there are very few cases reported. Tachycardia and arterial spasms occasionally occur because of accidental overdosing or interactions. There are no specific antidotes, and none of the current treatments have proven efficacy.  

Here, we describe a young female who intentionally consumed approximately 20 mg of ergotamine and experienced vomiting, vasospasm, and tachycardia. Fortunately, her symptoms improved with the administration of conservation therapy, enoxaparin, nifedipine, and methylprednisolone. 

Clinicians should be aware of the potential risk of vasoconstriction associated with ergotamine/caffeine toxicity and closely monitor patients for these side effects.

For treatment of apnea of prematurity (AOP), aminophylline is the first line medication in Taiwan. There are limited trials in Taiwan regarding the therapeutic benefits and adverse effects of caffeine for the treatment of AOP. This observational study conducted between January 2018 and December 2018 investigated the clinical effectiveness and safety of caffeine for AOP in the neonatal intensive care unit (NICU) at a hospital in Taiwan. Very preterm neonates with very low birth weight and apnea were treated with a loading dose of caffeine citrate at 20 mg/kg, followed by a 5–10 mg/kg maintenance dose every 24 h. Preterm infants admitted to the NICU between January 2017 and December 2018 and treated with aminophylline/theophylline were included for comparison. Seventeen infants receiving caffeine therapy and 43 receiving aminophylline/theophylline therapy were enrolled in this study. Although fewer apneic spells were observed from the second week of commencing caffeine treatment (P=0.028), the mean duration of apnea and episodes of apneic spells during the first four weeks of treatment were similar between the two groups. There were no significant differences in short-term side effects, duration of intubation, noninvasive respiratory support, hospitalization, and medical expenses between the two groups. Caffeine treatment can reduce the frequency of apnea after one week of administration; however, both caffeine and aminophylline/theophylline showed similar effects in treating AOP.

Partial peripheral nerve injury often results in chronic pain, including hyperalgesia and allodynia. Caffeine, as a non-selective antagonist of adenosine receptors (ARs), has protective effects on neuropathic pain. Since nitric oxide (NO) is partially involved in the central effects of caffeine, we investigated the effects of acute caffeine administration on neuropathic pain, focusing on A1 and A2 receptors and the possible role of NO. 

Following chronic constriction injury (CCI), male Wistar rats were administered caffeine (10, 50, and 100 mg/kg). Also, groups of animals received L-NAME (30 mg/kg) or L-arginine (100 mg/kg) either alone or before treatment with 50 mg/kg of caffeine. Rats were tested for hyperalgesia and allodynia at 4, 7, 14, 21, and 28 days following CCI. 

Administration of 10 mg/kg of caffeine significantly increased cold allodynia, while 50 and 100 mg/kg of caffeine decreased mechanical allodynia and thermal hyperalgesia. Pre-treatment with L-NAME before caffeine administration decreased cold and mechanical allodynia and thermal hyperalgesia. Treatment with L-arginine before caffeine administration increased thermal hyperalgesia and decreased cold allodynia.

The present data show that caffeine dose-dependently affects the pro-analgesic or anti-analgesic states in the CCI model.

Post-dural puncture headache (PDPH) is the most common complication following spinal anesthesia among parturients undergoing cesarean section surgery. The purpose of this study was to evaluate the effectiveness of acetaminophen and caffeine in preventing PDPH.

This double-blind, randomized clinical trial was conducted on 96 obstetric women, who were candidates for elective cesarean section. Following the randomization of participants into two groups, participants in the intervention group received tablets of acetaminophen (500 mg)+caffeine (65 mg), and participants in the control group received placebo tablets orally 2 hours before spinal anesthesia induction and then every 6 hours after surgery up to 24 hours. All parturients were evaluated for frequency and intensity of PDPH every 6 hours until 24 hours after surgery and then 48 and 72 hours after surgery. Overall satisfaction during the first 72 hours of postpartum was evaluated. The data were analyzed using SPSS software. P<0.05 was considered statistically significant.

Participants in the intervention group were 70% less likely to experience PDPH after spinal anesthesia (OR=0.31 P=0.01, 95% CI [0.12-0.77]). They also experienced significantly milder headaches 18 hours, 48 hours, and 72 hours later. Participants in the intervention group reported higher levels of satisfaction at the end of the study (P=0.01). No side effects related to the intervention were reported.

Prophylactic administration of acetaminophen+caffeine decreases 70% the risk of PDPH and significantly attenuates pain intensity in obstetric patients who underwent spinal anesthesia for cesarean section.

Caffeine, the extensively honored central nervous system boost constitute in coffee, tea, and chocolate, has been considerably delved for its different impacts on health . While moderate input offers benefits like enhanced mood and alertness , inordinate consumption poses pitfalls, including headaches, pulsations, and anxiety.

Using histopathological and immunohistochemical methods, we aimed to examine the dose-dependent effects of chronic caffeine consumption on the recovery of burn wounds in an in vivo rat model.

Forty-five rats were randomly assigned to a high-dose group (20 mg/kg per day for eight weeks; n=15), a low-dose group (10 mg/kg per day for eight weeks; n=15), or a control group (n=15). The burn model was created in rats. The groups were separated into three subgroups (n=5) based on the day after injury (7th, 14th, or 21st day). The wound area, wound closure percentage, and histopathological and immunohistochemical reactivity were evaluated.

Successful wound healing was noted in rats treated with low doses of caffeine, similar to the control group. Pathology revealed low re-epithelization, low inflammation, and high granulation in the high-dose group. In addition, there was a significant difference between the control and high-dose groups regarding the immunohistochemical reactivity of αVβ3 integrin, VEGF, and MMP-9 (P<0.05).

We demonstrated that chronic caffeine consumption in rats adversely affects the recovery process of wounds in a dose-dependent manner. This effect may occur through delayed wound healing via the molecules MMP-9, αVβ3 integrin, and VEGF. Treatment that modulates these molecules can lead to enhanced and quicker recovery of damaged skin in coffee lovers.

Intravenous albumin administration increases blood circulation and enhances wound healing. Topical application of albumin can inhibit the growth of certain bacteria on topical wounds. Topical caffeine can induce vascularization and the formation of blood vessels on the skin. The purpose of this work is to explore for the first time the effect of topical albumin and caffeine on wound healing rate in rat models.

This work aimed to develop albumin and caffeine-loaded nanofibers by the electrospinning method and to evaluate their topical effect on wound healing.  Nanofiber formation was assessed by SEM and considered using FT-IR spectroscopy. The therapeutic activity of topical albumin and caffeine was investigated on a full-thickness excision skin model.  

Albumin alone or in combination with caffeine effectively reduced the exposed wound area.  Wound contraction at the end of week 2 was higher in albumin and caffeine loaded nanofiber group (96%) relative to the control group (79%).

Data show that daily albumin-loaded wound dressing displayed good healing properties and enhanced wound closure rate. These findings may indicate the successful application of the sauce as a promising tool in wound healing therapy.

The role of caffeine as a brain stimulant in improving the respiratory characteristics of patients under mechanical ventilation is unclear. This study aimed at determining the effect of oral caffeine in helping to release (Liberation) from the ventilator in intubated patients under mechanical ventilation admitted to the intensive care unit.
General ICU patients with more than 48 hours of dependency on a ventilator were randomly divided into two groups. The intervention group received 200mg caffeine tablets twice a day through a gastric tube, while the control group received a placebo of the same amount. Every day, patients were assessed for the likelihood of being disconnected from the device. If their clinical condition was deemed suitable, the device mode was switched to spontaneous, and their Rapid Shallow Breathing Index (RSBI) was calculated. Based on this information, a decision was made regarding whether to proceed with weaning.
Caffeine use in ICU patients significantly reduced the airway resistance index of patients (P <0.05). However, although this drug reduced the length of hospital stay in the ICU and the duration of intubation of patients, these changes were not statistically significant (P> 0.05).
Caffeine may improve respiratory status and reduce the duration of intubation and hospitalization in the ICU.

Caffeine is an edible chemical compound obtained from various plants, such as tea and coffee. Caffeine is an alkaloid that is highly hydrophilic and has limited skin permeability. The lipophilic nature of the stratum corneum is a major barrier to the passage of this substance through the skin. Topical drug delivery systems can effectively transfer caffeine to the skin.

This study investigated the effect of pretreatment time with chemical enhancers on caffeine’s skin permeation.

The skin was subjected to additives such as sodium lauryl sulfate, sodium lauryl ethyl sulfate, tynoline, nanoxinol, and lecithin for 5, 15, and 30 minutes. Then, the parameters of caffeine permeability and structural changes in the skin due to additive adsorption were studied using Fourier Transform Infrared (FT-IR) spectrometry.

The enhancers increased the permeation of caffeine through the skin. There are different mechanisms for penetration enhancers, including lipid liquefaction, disruption of lipid bilayers, and irreversible denaturation of intracellular keratin.

Sodium lauryl sulfate can affect the skin permeability of caffeine.

Due to its stimulatory effects, caffeine is one of the most frequently consumed mood and behavior altering beverages. It is commonly used to improve alertness in cases of fatigue after prolonged work. Health authorities recommend not to exceed a daily intake of <200 mg/day. The purpose of this study is to measure the prevalence of unsafe caffeine daily consumption (>200 mg/day), detect caffeine withdrawal and intoxication symptoms, and investigate the relationship between caffeine intake and stress and sleeping hours.

168 anesthesiologists answered a questionnaire during the period of April to July 2022. After estimating daily consumption of caffeine, anesthesiologists were classified into either safe level group (daily consumption ≤ 200 mg/day), or unsafe level group (daily consumption >200 mg/day); then, further analysis was done.

Almost 80% of the total participants were unsafe consumers. Junior doctors and registrars (group J) had a statistically higher caffeine consumption than consultants (group S) (433.9±228.7 mg versus 363.6±244.5 mg, respectively; P=0.017). Additionally, 45% of group J experienced intoxication symptoms, and 54% experienced withdrawal symptoms. These symptoms had a significantly higher prevalence in group J compared to group S (P=0.001 and P=0.004, respectively). Finally, no significant correlation was found between average daily caffeine consumption and daily sleeping hours and stress scale score (P=0.831 and P=0.324, respectively).

The consumption of caffeine-containing drinks among anesthesiologists was very high. Junior anesthesiologists specifically reported higher caffeine consumption, more intoxication and withdrawal symptoms, and a higher stress score than consultants.

One of the most critical public health issues in psychiatric and medical concerns is methamphetamine (METH) dependence.

The present study aimed to investigate caffeine (Rescuecaf) effectiveness in reducing craving and relapse prevention in METH dependence.

In this double-blind, randomized clinical trial, 15 participants in the experimental group received 4.5 mg/kg of caffeine (with an average daily dose of 300 mg for each participant for three months), and 15 patients with METH use disorder were treated with the placebo. Addiction severity was measured daily using the addiction intensity index (ASI). The Amphetamine Withdrawal Questionnaire (AWQ), Amphetamine Selective Severity Assessment (ASSA), and Drug Complications Questionnaire were used for data collection. Statistical analysis was carried out on weeks 1, 6, and 12 after the intervention and between caffeineand placebo-treated patients based on repeated measures and multivariate analysis of variance (MANOVA) at the 95% confidence interval.

There was a significant difference between the experimental and placebo groups in METH-dependency and deprivation symptoms. In addition, in the experimental group, there was a significant difference between weeks 1, 6, and 12 (P > 0.05), but no significant difference was found between weeks 6 and 12. No significant side effects were seen during caffeine consumption during the second, fourth, and sixth weeks.

Caffeine is an efficient, new drug capable of managing amphetamine withdrawal syndrome.

The availability of energy drinks on the global market result from intensive marketing campaigns in the media. The purpose of this study was to evaluate the consumption of energy drink and its potential effect on sleep patterns of consumers.

A descriptive cross-sectional design with self-administered questionnaire was used for this survey. An online survey using google forms was created for the validated questionnaires after pre-testing and the link shared on different social media platforms. Period of data collection lasted between January and September, 2020.

A total of 384 participants were involved in this study. From the study, prevalence of energy drink consumption in the metropolis is 61.5% (n=236). A percentage of 69.1 % (n=163) of the consumers are males relative to 30.9% (n=73) who are females. Results from the study indicate that most patronized energy drink in the metropolis has energy value per 100 ml of 158 kJ with no proteins and fats but an 8.9 g of carbohydrate. The caffeine content of this energy drink is 0.012% and 13% glucose syrup. A total of 29.6% (n=70) of energy drink consumers indicated it to be their preference. Least consumed energy drink (0.85%) has 30-35 mg/100 ml of caffeine with about 192 kJ energy value. Furthermore, results point out that 70.8% (n=167) of the consumers experienced change in sleep pattern. Although other factors may have caused this change in sleep pattern, Pearson Chi-Square result (x2 = 83.277, p≤0.01) reveals that indeed there is association between energy drink consumption and change in sleep pattern as majority of energy drink consumers indicated that they usually experience changes in wake-up time and/or bedtime.

The study has demonstrated that majority of the youth in the Kumasi Metropolis consume energy drinks which ultimately causes change in their sleep pattern. This change can alter their daily activities and health status.