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A Case Approach to Perioperative Drug-Drug Interactions pp 917–920Cite as

Caffeine Crash

Fatal Forty DDI: caffeine, ethinyl estradiol, ciprofloxacin, CYP1A2

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Abstract

This case discusses the pharmacokinetic interaction of caffeine, ethinyl estradiol, and ciprofloxacin, resulting in caffeine toxicity Caffeine is a cytochrome P450 1A2 substrate. Both ciprofloxacin and ethinyl estradiol inhibit 1A2. The physiologic effects of ingestion of high doses of caffeine are also reviewed.

Keywords

  • Pharmacokinetic
  • Caffeine
  • Inhibition
  • Inhibitor
  • Seizure
  • Ethinylestradiol
  • Ciprofloxacin
  • Methylxanthine
  • CYP1A2
  • Cytochrome
  • P450
  • 1A2
  • Cafergot
  • Adenosine
  • Status epilepticus
  • Oral contraceptive
  • OCPs
  • Alertness
  • Coffee
  • Cola
  • Cocoa
  • tea
  • Cimetidine
  • Fluvoxamine

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, University of California San Diego, San Diego, CA, USA

    Brian Gierl MD

  2. Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Ryan Romeo MD

Authors
  1. Brian Gierl MD
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  2. Ryan Romeo MD
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Corresponding author

Correspondence to Brian Gierl MD .

Editor information

Editors and Affiliations

  1. Anesthesia Services Department, Philadelphia Veterans Affairs Med Center, Philadelphia, PA, USA

    Catherine Marcucci MD

  2. Department of Anesthesiology, Oregon Health and Science University, Portland, OR, USA

    Michael P. Hutchens MD

  3. Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA

    Erica D. Wittwer MD, PhD, Toby N. Weingarten MD, Juraj Sprung MD, PhD & Wayne T. Nicholson MD, PharmD, MSc, ,  & 

  4. Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA

    Kirk Lalwani MD

  5. Department of Anesthesiology, University of Pittsburgh School of Med Liliane S. Kaufmann Building, Pittsburgh, PA, USA

    David G. Metro MD

  6. Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, USA

    Randal O. Dull MD, PhD

  7. Department of Anesthesiology, Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA

    Christopher E. Swide MD

  8. Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA

    F. Jacob Seagull PhD

  9. Professor and Chair, Department of Anesthesiology and Perioperative Medicine, Portland, OR, USA

    Jeffrey R. Kirsch MD

  10. Department of Psychiatry, University of Maryland Medical System VA Maryland Health Care System, Baltimore, MD, USA

    Neil B. Sandson MD

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Gierl, B., Romeo, R. (2015). Caffeine Crash. In: , et al. A Case Approach to Perioperative Drug-Drug Interactions. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7495-1_206

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  • DOI: https://doi.org/10.1007/978-1-4614-7495-1_206

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