카페인 경구제제를 과량 복용한 후 발생한 bigeminy 1예

Abstract

Caffeine is a very popular compound widely available in various beverages. It is generally regarded as safe, but several lethal outcomes have been reported after large overdoses.A 21-year-old woman was brought to the emergency department (ED) after ingestion of approximately 100caffeine tablets, each containing 200 mg, resulting in a total amount of about 20,000 mg of caffeine. She was very irritable and complained about nausea, vomiting, and headaches. While the initial electrocardio graphy (ECG)showed ventricular bigeminy, most of the patient’s symptoms were gone after supportive care with anti-emetics and benzodiazepine. The rhythm was converted to a sinus rhythm without anti-arrhythmics. Because caffeine tablets are unavailable in Korea, acute large-dose caffeine overdoses have been relatively rare. However, there is an increasing risk of caffeine exposure through highly concentrated “energy drinks” or caffeine tablets from purchases on-line. Thus, physicians should be prepared to deal with the severe toxic effects of an acute caffeine over-dose.