Treatment of caffeine toxicity with metoprolol

Am J Emerg Med. 2019 Mar;37(3):562.e5-562.e10. doi: 10.1016/j.ajem.2018.11.038. Epub 2018 Nov 26.

Abstract

A 27-year-old man presented with an intentional overdose of concentrated caffeine powder that he bought over the internet. The patient received benzodiazepines and ondansetron for symptomatic treatment when he arrived in the Emergency Department (ED). Subsequently, he developed recurrent supraventricular tachycardia in the ED. The SVT was successfully treated with metoprolol. The patient's caffeine level was >90 mg/L. This is the first known report of treatment of caffeine-induced supraventricular tachycardia with metoprolol.

Keywords: Adenosine; Caffeine; Metoprolol; Suicide; Supraventricular tachycardia; Toxicology.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Arrhythmia Agents / therapeutic use*
  • Caffeine / poisoning*
  • Drug Overdose / drug therapy*
  • Electrocardiography
  • Emergency Service, Hospital
  • Humans
  • Male
  • Metoprolol / therapeutic use*
  • Suicide, Attempted
  • Tachycardia, Supraventricular / chemically induced*
  • Tachycardia, Supraventricular / diagnosis
  • Tachycardia, Supraventricular / drug therapy*

Substances

  • Anti-Arrhythmia Agents
  • Caffeine
  • Metoprolol