![]() Some are consumed on their own, while others are used to make mixed drinks. Carbonated waterĬarbonated water, which is always free of caffeine, includes seltzer water, tonic water, club soda, and sparkling water. Both Canada Dry and Schweppes provide a diet option, both of which are caffeine-free. ![]() Smaller companies may also use natural flavors, or even whole ginger root, so check the ingredient list if you’re unsure.Īnother well-known ginger-ale manufacturer is Schweppes. While most ginger ales are artificially flavored, the Canada Dry brand uses real ginger extract to flavor its drink. Ginger ale is a ginger-flavored soda often used in mixed drinks or as a home remedy for nausea. However, the lemon-lime sodas Mountain Dew, Diet Mountain Dew, and Surge are caffeinated. Well-known lemon-lime sodas include Sprite, Sierra Mist, 7 Up, and their diet versions. Lemon-lime sodas are citrus-flavored and usually caffeine-free. There are several varieties of clear soda, most of which are caffeine-free. They do not contain phosphoric acid, which gives dark soft drinks their deep brown hue ( 1). Imminent cardiac arrest in caffeine toxicity should prompt intra-lipid therapy to scavenge the free serum caffeine.Unlike dark colas like Coke and Pepsi, clear sodas are typically colorless - or light enough in color that you can see through them. Caffeine exhibits ideal characteristics to be dialyzed, including low protein binding (36%), low molecular size (194), and a small volume of distribution (0.6 to 0.8 L/kg). Hemodialysis has been effective in severe, life-threatening caffeine ingestions. Īctivated charcoal can bind caffeine if the ingestion is recent, and repeated doses can help diminish serum levels via the enterohepatic circulation. Vasopressors, such as vasopressin or phenylephrine, can be used to maintain blood pressure (goal mean arterial pressure greater than 65 mm Hg) without worsening tachycardia. Procainamide, lidocaine, or bicarbonate have also been utilized for the treatment of tachydysrhythmias. Beta-blockade with esmolol is useful for tachycardia. Hydration may be oral in minor cases, yet severe cases benefit from intravenous (IV) hydration. The primary treatment for minor caffeine ingestion is supportive. įatal caffeine overdose is relatively uncommon, and treatment data is limited to case reports. ![]() Cardiac monitoring allows evaluation of heart rate and early recognition of dysrhythmias such as ventricular ectopy or fibrillation. An electrocardiogram may demonstrate tachycardia, ST-segment depressions, or T-wave inversions. ![]() It is also important to obtain serum myoglobin and creatine kinase levels to monitor for rhabdomyolysis. ![]() Caffeine toxicity can result in hypokalemia, hypocalcemia, hyponatremia, and hyperglycemia. Ī venous blood gas may demonstrate anion gap metabolic acidosis, which can be severe. Lethal blood levels are typically above 80 to 100 mg/L, although one case occurred at 15 mg/L. Although not available in all hospitals, serum caffeine levels are generally obtained with an immunoassay. Serum caffeine levels can guide prognosis and therapy. Routine serum laboratory evaluations can be useful in drug overdose cases, especially in the setting of unstable vital signs, seizures, or altered sensorium. ![]()
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