1. Nikki, Bryan, Kyla

3. Caffeine Caffeine is one of the most widely used drugs in the world.
It is estimated that ______% of adults in the United States regularly drink caffeinated beverages.
It has also been estimated that the average adult caffeine intake in the United States is 200 to 400 mg per day.
Caffeine can be found in all sorts of things like coffee, energy drinks, soft drinks, chocolate, migraine medicine, tea, dietary supplements, etc.
Caffeine is normally consumed orally through the beverages or food in which it is present.

4. Caffeine Caffeine is a psychoactive drug that acts as a CNS stimulant
Its chemical name is 1,3,7-trimethyl-1H-purine-2,6(3H,7H)-dione
Its generic name is Caffeine
Some brand names are_______________

5. Primary Uses Caffeine has many uses
It does not affect all people in the same way
Most people who do consume caffeine do so on regular basis
Athletes use caffeine to improve their performance and be on top of their game
_________ sufferers use caffeine to alleviate their pain
Night shift employees or truck drivers may use it to make fewer mistakes as a result of being tired or to increase alertness during sleep deprivation
Students may use caffeine to stay up late studying
It is primarily used as a mild CNS stimulant to aid in staying awake and restore mental alertness

6. Behavioral Effects
There are numerous behavioral effects for primary use and some major side effects
Studies demonstrated _________ effects in rodents
At low doses it had stimulant effects
At high doses rodents showed reduced activity levels.
Humans do not show behavioral depression but they do experience tension and anxiety at higher doses
Caffeine does more than just increase arousal. There are a variety of positive subjective effects, such as:
Feelings of well-being, enhanced energy or vigor, increased alertness and ability to concentrate, self-confidence, increased work motivation, enhanced sociability, and reduced tension

7. Undesirable Side Effects
There are multiple unwanted or undesirable side effects as well, such as:
increased blood pressure and respiration rate, enhanced water excretion, etc.
Caffeine has a positive ionotropic effect on the myocardium and chronotropic effect on the sinoatrial node
Results in a transient increase in heart rate, force of contraction, and cardiac output
Some additional side effects are as follows but not limited to; nervousness, insomnia, restlessness, irritability, confusion, agitation, delirium, twitching, tremors, convulsions, tingling of face, flushing, palpitation, nausea, vomiting, epigastric discomfort, gastric irritation, diarrhea, etc.

8. Background and History of Coffee
________________, a coffee plant with berries
Arabian tale about Kaldi and his goats
This shows early evidence that coffee provides energy
They think that coffee crossed the Red Sea early in its history, as early as A.D. 575
It arrived in England in the early 1600s as a medicine
First English coffeehouse opened in Oxford in 1650, and others soon after in London
There was some time of political turmoil
It has been said that “England’s great struggle for political liberty was fought and won in the coffeehouse
*Kaldi saw his goats acting exuberantly on a hillside, and traced the cause to some berries where the goats were grazing. Kaldi tried the berries and soon he had joined the goats. He took the berries to a holy man, who said the drug would aid in prolonging the stamina of dervishes (a Muslim member, some of which carry on ecstatic observances, such as energetic dancing and whirling or vociferous chanting or shouting.)

9. Background and History of Coffee
By 1690, coffeehouses were firmly established in English life
Helped reduce drunkenness during the gin epidemic in the early 1700s
However, coffee consumption decreased from 3.1 cups a day for adults in 1960 to only 1.75 cups per day in 1991
People were trying to be more health conscious
*But coffee consumption has increased again due to gourmet coffee, and the fact that it is affordable and a socially acceptable drug.
*If you would like to know how to make The Perfect Cup of Coffee, you can read the reserved reading #5 on Moodle ;)

10. Mechanisms of Action
The mechanisms of action, neurotransmitter systems, and the receptor subtypes are not completely clear, but much progress has been made with time
Caffeine is rapidly absorbed
Reaches peak concentration within ______ minutes.
It is water-soluble and lipid-soluble, which allows it to cross the BBB
It has a wide distribution and an almost immediate effect on alertness
Originally it was thought that it directly influenced catecholamine systems, and that it was an inhibitor of cAMP phosphodiesterase. It was thought that it blocked GABA(A) receptors and that it stimulated CA++ release within cells

11. Mechanisms of Action
More recent studies have led us to believe that it actually blocks A1 and _____ receptors for adenosine
Adenosine plays a role in energy via adenosine triphosphate (ATP)
Adenosine in the brain can serve a neurotransmitter-like function
Caffeine reduces the effects of adenosine by binding to adenosine receptors, but not activating them
There are four different adenosine receptor subtypes A1, A2A, A2B, and A3

12. Mechanisms of Action
Caffeine is thought to block A1 and A2A receptor subtypes in laboratory animals
These receptor subtypes are thought to mediate most of the behavioral effects of caffeine
A1 and A2A receptors
A1 receptors thought to inhibit calcium uptake
A2A receptors are thought to play a role in behavioral control and interact with the _____ system
_____ system is intertwined with reward and arousal
Growing evidence from animal studies demonstrate that adenosine is a sleep- or drowsiness- inducing factor released after a period of waking
Explains why caffeine use in humans causes increased alertness and suppression of sleep

13. Absorption and Metabolism
There are several factors related to route of administration, absorption, distribution, and fate
Caffeine is rapidly absorbed. It is actually peaks minutes after administration
It is widely distributed throughout the body, and metabolized in the liver
Metabolites account for almost all caffeine excretion
Only 1 to 2% is excreted unchanged
In humans approximately ____% of caffeine metabolites are eliminated through urine, 2-5% through feces, and the remainder through body fluids like saliva
Metabolism is influenced by prior ingestion of caffeine, gender, smoking status, and other drugs

14. Interactions With Other Drugs
Cigarette smoke used repeatedly causes an increase in a liver enzyme known as ________________________
This speeds up the rate of biotransformation/metabolism of caffeine
People who are heavy smokers may need higher doses of caffeine, because it is metabolized by the same enzyme
Caffeine also interacts with other drugs
It increases the effects of cimetidine and theophylline toxicity

15. Half Life Caffeine’s half-life is _____ hours in adults
The half life in neonates ranges from 36 to 144 hours
It is also excreted in small amounts in the breast milk
Caffeine is classified as a FDA pregnancy category B, meaning it freely crosses the placenta

16. Caffeine Tolerance
Regular caffeine use can lead to tolerance to some of caffeine’s subjective effects as well as disrupt sleep
Chronic caffeine use can produce tolerance to the cardiovascular and respiratory effects of the drug
Some withdrawal symptoms are:
Headache, lethargy, fatigue, impaired concentration, impaired psychomotor performance, and in some cases mild anxiety or depression

17. Physiological Effects
Heavy coffee drinking has been linked with increased blood pressure and a heightened risk of coronary heart disease
High caffeine consumption has also been reported to be associated with low infant birth weight

18. Other Effects
Chronic ingestion of excessive amounts of caffeine can lead to a syndrome called ____________.
Caffeinism is characterized by restlessness, nervousness, insomnia, and physiological disturbances, such as tachycardia and gastrointestinal upset.
Extremely high doses of caffeine may produce even more severe psychiatric effects.
Caffeine consumption causes physical dependence and can also lead to a compulsive use pattern.
Caffeine is reinforcing to regular users. Caffeine reinforcement is related to a combination of functional enhancement and relief from withdrawal symptoms.

19. Addiction??? Components Model of Addiction (Griffiths) Excessive?
Mood Modification?
Salience?
Tolerance?
Withdrawal?
Conflict?
Relapse?

22. References
Berardi, R.R. (2009). Handbook of nonprescription drugs an interactive approach to self-care (16th ed.). Ann Arbor, MI :American Pharmacists Association
Hardman, J. G., Limbird, L.E. (Eds). (2001). The pharmacological basis of therapeutics
(10th ed.). New York, NY: McGraw Hill Medical Publishing Division.
Meyer, J.S., Quenzer, L.F (2005). Psychopharmacology drugs, the brain, and behavior. Sunderland, MA: Sinauer Associates, Inc.
Murray, L. (Ed.). (2008).PDR for nonprescription drugs, dietary supplements, and herbs
(29th ed.). Montvale, NJ: Thomson Healthcare Inc.
Shannon, M.T., Stang, C.L., Wilson, B. A. (1995). Drugs and nursing implications (8th ed.). Norwalk, CT: Appleton and Lange.
Shannon, M.T., Stang, C.L., Wilson, B. A. (1998). Nurses drug guide. Stanford, CT:
Appleton and Lange
Reserved Reading #5 from Moodle

23. Questions???