At lower dosages, caffeine follows first-order elimination kinetics. Caffeine metabolites are excreted in urine. It is metabolized into active methylxanthine metabolites through liver cytochrome P450 1A2 (CYP1A2), including 3% to 10% into theophylline. The main pharmacokinetic features of caffeine are rapid absorption when ingested orally, with a peak level in blood reached within 30 to 120 min, depending on the formulation. Bronchodilation can also be explained by A1 receptor antagonism, the catecholamine release is associated with headache and vomiting. Furthermore, caffeine acts as a PDE4 inhibitor causing bronchospasm, increased gastric secretions, headache, and vomiting. Hypotension is mediated by β2 adrenergic receptor-agonism while the diuretic effect is due to adenosine A receptor antagonism. Tachycardia can be explained by phosphodiesterase (PDE) 3 inhibition, A1 receptor antagonism, and catecholamine release. In addition, it exerts cardiovascular effects (chronotropic effect, hypotension, diuresis). Moreover, caffeine slightly increases the release of norepinephrine and dopamine, enhancing the neural activity of numerous brain areas. The absorption of adenosine by the CNS cells is one of the mechanisms that triggers sleep and sedation. It is a central nervous system (CNS) stimulant through its blockage of adenosine receptors, mainly A1 and A2A subtypes, thus competitively antagonizing their action. Ĭaffeine is a methylxanthine, in the same group as theophylline. Caffeine may be derived from other ED ingredients such as guarana and yerba mate, and is also a component of some medicines.
The most concentrated EDs are usually called energy shots and can have up to 350 mg per unit. The content of caffeine depends on the brand, ranging from 80 mg to 320 mg per unit. A standard 250 mL ED contains 80 mg, which is equivalent to an average cup of coffee. The purpose of this narrative review is to outline the potential interactions of EDs with medication and drugs of abuse, and perform a literature search of reports of intoxication, even those with fatal consequences.Ĭaffeine is a common ingredient in all EDs. Additionally, an association with suicide plan/attempt in a paediatric population with a frequent use of EDs (≥5 times/week) has been described. Furthermore, several studies suggest that EDs may serve as a gateway to other forms of substance dependence. In recent years, many authors have observed that ED intake causes adverse effects, including high blood pressure, changes in corrected QT interval (QTc), serious cardiovascular events, digestive and kidney disorders, metabolic adverse effects, poor sleep, neuropsychiatric adverse effects, seizures, and death. Young people report ED consumption as conferring increased energy, augmented alertness, and improved athletic performance. The short and long-term health effects of many of these ingredients, and ED consumption in general, are, for the most part unknown. Depending on the brand, other components include guarana (a plant containing concentrated caffeine), taurine, ginseng, Ginkgo biloba, 5-hydroxytryptophan, bitter orange, B vitamins, yerba mate, glucuronolactone, and high sugar content. Regarding consumption of EDs with recreational drugs, alcohol was the first concomitant drug (74.4%), followed by tobacco (40%), cannabis (31.3%), sedatives (8.3%), cocaine (1.85%), and ecstasy (1.3%). Prevalence was found to be higher in boys (49.7%) than girls (31.1%). The latest Survey on Drug Use in Secondary Schools in Spain (ESTUDES survey), designed to collect data on situations and trends in drug use and other addictions among secondary school students aged 14 to 18 years, reported that 4 out of 10 had drunk EDs in the previous 30 days. In the same report, 4% to 5% of students in all three grades reported use of one or more energy shots per day, each typically coming in containers of two to three ounces.
In the 2019 survey of Monitoring for the Future, between 10% and 12% of students in 8th, 10th, and 12th grades reported using one or more EDs per day in the United States. In Europe, 48% of university students using EDs had taken them with alcohol while in Australia half of respondents reported mixing alcohol and EDs at least once in the last year. For instance, one in four youths in North America had consumed alcohol with EDs during the previous year. Combining EDs with alcohol is also popular among young people, either as a mixed cocktail or in the same drinking session. In a European one, 13% of daily caffeine intake in adolescents was from EDs. In a United States national survey, the greatest prevalence of ED consumption was found among 13–24 years old (10% of caffeine consumers). Since the 1980s, the consumption of energy drinks (EDs) has increased, with teenagers and young adults representing the principal consumers.
0 kommentar(er)
