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Study Title and Description

Coca-Cola and kangaroos.



Key Questions Addressed
1 For [population], is caffeine intake above [exposure dose], compared to intakes [exposure dose] or less, associated with adverse effects on acute toxicity*?
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Primary Publication Information
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TitleData
Title Coca-Cola and kangaroos.
Author DW Mudge,DW Johnson,
Country
Year
Numbers

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: Acute Toxicity - Study Design Details
Arms
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Design Details
Question... Follow Up Answer Follow-up Answer
Refid 15451232
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What outcome is being evaluated in this paper? Acute
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What is the objective of the study (as reported by the authors)? a case report of a 44 year old previously fit and well individual with sudden onset of muscle weakness. Individual admitted consuming 4L coca-cola most days and up to 10L at night
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Provide a general description of the methods as reported by the authors. Information should be extracted based on relevance to the SR (i.e., caffeine related methods) caffeine was self reported, this was an emergency visit due to muscle weakness, Thyroid was tested, urine analyzed, blood work done, respiratory function decreasing treated with intubation and low potassium t
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How many outcome-specific endpoints are evaluated? 6
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What is the (or one of the) endpoint(s) evaluated? (Each endpoint listed separately) respiratory function decreased -
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List additional health endpoints (separately). ECG
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List additional health endpoints (separately) muscle weakness
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Notes
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Clinical
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Physiological
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Other
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What is the study design?
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Randomized or Non-Randomized?
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What were the diagnostics or methods used to measure the outcome? Both
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Optional: Name of Method or short description assessment by doctor (respiratory and muscle); blood work, urinalysis and thyroid tests would be standard ER labs
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Caffeine (general) Caffeine (general)
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Coffee
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Chocolate
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Energy drinks
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Gum
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Medicine/Supplement
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Soda Soda
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Tea
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Measured
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Self-report Self-report
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Children
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Adolescents
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Adults Adults
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Pregnant Women
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What was the reference, comparison, or control group(s)? (e.g. high vs low consumption, number of cups, etc.) none - this is a case report
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What were the listed confounders or modifying factors as stated by the authors? (e.g. multi-variable components of models.  Copy from methods) authors did note that this may not have been "acute" as individual claimed to drink between 4-10L for previous 3 years (my comment: what is not clear is if he meant while hunting, or all the time)
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Provide a general description of results (as reported by the authors). muscular weakness (graded 2/5); respiratory function deteriorated requiring intubation, blood tests showed hypkalaemia and increased serum creatine kinase, urinalysis showed kaluresis, thyroid function and drug tests were normal, ECG showed T wave flattening and U waves.
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Did the authors perform a dose-response analysis (or trend/related analysis)? No
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What were the authors's observations re: trend analysis?
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What were the author's conclusions? that sugar from the cola or caffeine from the cola was responsible for the effects. "Caffeinated and/or hyperosmolar beverages should be considered as a cause of unexplained hypokalemia with osmotic diuresis and kaluresis"
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What were the sources of funding? none stated
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What conflicts of interest were reported? none reported
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Does the exposure (dose) need to be standardized to the SR? Yes
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Provide calculations/conversions for the exposure based on the decision tree in the guide (for all endpoints/exposure levels of interest). (caffeine value provided by authors) 97 mg caf/L cola x 4 L = 388 mg 97 mg caf/L cola x 10 L = 970 mg
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List all the endpoint(s) followed by the dose (mg) which will be used in comparison to Nawrot.  Characterize value as LOAEL/NOAEL, etc. if possible.  acute toxicity (muscle weakness/hypokalemia) associated with 388mg-970mg/day caffeine; note they suggested 97mg/L for Coca-cola with ingest of 4-10L.
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Notes regarding selection/listing of endpoints and exposures/doses to be compared to Nawrot. This was self reported and no blood work for caffeine was conducted
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What is the importance of the study with respect to the adverseness of the outcome? Important
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Baseline Characteristics
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Results & Comparisons

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Adverse Events
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