OTC Drug Toxicity: Caffeine, Theophylline, and Antihistamine
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Questions and Answers

What is the approximate acute toxic dose of caffeine?

  • 5-10 g (correct)
  • Over 50 g
  • 1 g
  • 20-30 g

    • Which cardiovascular effect may be observed in caffeine toxicity?

  • Bradycardia
  • Hypotension
  • Hypertension
  • Ventricular fibrillation (correct)

    • What is the treatment for supraventricular tachycardia in caffeine toxicity?

  • Lignocaine
  • Beta-adrenergic antagonists (correct)
  • Cardioversion
  • Calcium channel blockers

    • What is a common symptom of theophylline toxicity related to oral tablets?

    <p>Nausea</p> Signup and view all the answers

    What is an uncommon symptom of theophylline toxicity?

    <p>Coma</p> Signup and view all the answers

    Which symptom is NOT associated with theophylline toxicity?

    <p>Bradycardia</p> Signup and view all the answers

    What is the first step in the treatment of theophylline toxicity?

    <p>Gastric lavage</p> Signup and view all the answers

    Which mechanism is proposed for the toxicity of methylxanthines?

    <p>Increased calcium release from intracellular sites</p> Signup and view all the answers

    Which of the following is true about the distribution of caffeine and theophylline in tea leaves?

    <p>Both are equally distributed in tea leaves</p> Signup and view all the answers

    How are xanthine derivatives eliminated from the body?

    <p>Through the liver metabolism</p> Signup and view all the answers

    What is the half-life of xanthine derivatives in nonsmokers?

    <p>3 to 15 hours</p> Signup and view all the answers

    Where is caffeine commonly found?

    <p>Coffee, tea, chocolate, and cola beverages</p> Signup and view all the answers

    Which source contains the highest amount of caffeine?

    <p>Brewed coffee</p> Signup and view all the answers

    Which compound is metabolized by the liver to methylxanthine and methyluric acid derivatives?

    <p>Theophylline</p> Signup and view all the answers

    What is the main mechanism that appears to cause nausea and vomiting due to methylxanthine toxicity?

    <p>Stimulation of chemoreceptor trigger zone</p> Signup and view all the answers

    What is the common half-life of xanthine derivatives in adult smokers?

    <p>4 to 5 hours</p> Signup and view all the answers

    What is the chemical class of caffeine, theophylline, and theobromine?

    <p>Alkaloids</p> Signup and view all the answers

    What are the main compounds found in tea leaves?

    <p>Caffeine, theophylline, and theobromine</p> Signup and view all the answers

    What is the proposed mechanism for methylxanthines toxicity?

    <p>Inhibition of cyclic nucleotide accumulation</p> Signup and view all the answers

    What is the main mechanism of toxicity of methylxanthines?

    <p>Increased calcium release from intracellular sites, Accumulation of cyclic nucleotides (especially cAMP), Adenosine receptor blockade</p> Signup and view all the answers

    What is the approximate half-life of xanthine derivatives in nonsmokers?

    <p>3 to 15 hours</p> Signup and view all the answers

    Which compounds are naturally occurring xanthine derivatives?

    <p>Caffeine, Theophylline, Theobromine</p> Signup and view all the answers

    Where is caffeine ubiquitously distributed?

    <p>Coffee, Tea, Chocolate, Cola beverages</p> Signup and view all the answers

    What is the distribution time for xanthine derivatives after oral absorption?

    <p>Within two hours</p> Signup and view all the answers

    Which organ metabolizes the compounds to methylxanthine and methyluric acid derivatives?

    <p>Liver</p> Signup and view all the answers

    What is the source containing the highest amount of caffeine?

    <p>Brewed coffee</p> Signup and view all the answers

    What is the main cause of nausea and vomiting in methylxanthine toxicity?

    <p>Direct stimulation of the chemoreceptor trigger zone</p> Signup and view all the answers

    What is the approximate acute toxic dose of caffeine?

    <p>200-400 mg</p> Signup and view all the answers

    What is the treatment for supraventricular tachycardia in caffeine toxicity?

    <p>Adenosine</p> Signup and view all the answers

    What is the main route of elimination for xanthine derivatives from the body?

    <p>Kidney</p> Signup and view all the answers

    What are the xanthine derivatives metabolized into by the liver?

    <p>Methylxanthine and methyluric acid derivatives</p> Signup and view all the answers

    What are the potential cardiovascular effects of caffeine toxicity?

    <p>Tachycardia, ventricular fibrillation, and cardiopulmonary arrest</p> Signup and view all the answers

    How can potentially lethal ingestions with life-threatening complications be managed in caffeine toxicity?

    <p>Charcoal haemoperfusion</p> Signup and view all the answers

    What are the common symptoms of theophylline toxicity related to controlled-release dosage forms?

    <p>Convulsions, hypothermia, ataxia, visual hallucinations</p> Signup and view all the answers

    What are the metabolic disturbances associated with theophylline toxicity?

    <p>Hypokalaemia, hyperglycaemia, hypercalcaemia, and metabolic acidosis</p> Signup and view all the answers

    What are the treatment options for hypotension refractory to fluids and vasopressors in theophylline toxicity?

    <p>Alpha-adrenergic drugs such as levarterenol</p> Signup and view all the answers

    What are the common initial symptoms associated with caffeine withdrawal?

    <p>Headache, anxiety, fatigue, and craving behavior</p> Signup and view all the answers

    What are the signs of antihistamine toxicity?

    <p>Tremors, excitable auditory and visual hallucinations, dry mouth, dry, hot skin, heart palpitations</p> Signup and view all the answers

    What is the proposed mechanism for caffeine withdrawal?

    <p>Demonstrated abruptly within 12 to 24 h after the last dose, initial symptoms last for about one week</p> Signup and view all the answers

    What is the proposed mechanism for tolerance to theophylline?

    <p>Tolerance to the diuretic action and the insomnia, but no tolerance develops to the CNS stimulation or bronchodilation</p> Signup and view all the answers

    What are the potential treatment options for hyperthermia and rhabdomyolysis in theophylline toxicity?

    <p>Dantrolene, hydration, and maintenance of high urine output</p> Signup and view all the answers

    What are the indications for haemoperfusion in theophylline overdose?

    <p>Intractable convulsions, persistent hypotension, uncontrollable arrhythmias, and serum theophylline levels greater than 60 to 80 mcg/ml</p> Signup and view all the answers

    What are the symptoms of caffeine toxicity related to theophylline?

    <p>Nausea, cardiac arrhythmias</p> Signup and view all the answers

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