Home Drug Guide Caffeine Citrate

Drug Guide

Generic Name

Caffeine Citrate

Brand Names Cafcit

Classification

Therapeutic: Stimulant, Respiratory agent

Pharmacological: Xanthine derivative

FDA Approved Indications

  • Apnea of premature infants

Mechanism of Action

Caffeine citrate primarily acts as an antagonist of adenosine receptors in the central nervous system, leading to increased neuronal activity and stimulation of the respiratory center in the brain.

Dosage and Administration

Adult: Typically not used in adults; neonatal dosing is standard for apnea of prematurity.

Pediatric: Initial dose: 20 mg/kg IV loading dose, followed by maintenance doses of 5-10 mg/kg every 24 hours.

Geriatric: Not specifically indicated; use cautiously if applied.

Renal Impairment: Adjust dose due to decreased clearance; monitor levels.

Hepatic Impairment: Adjust dose; metabolized in the liver, but less data available.

Pharmacokinetics

Absorption: Rapidly absorbed intravenously.

Distribution: Widely distributed, crosses blood-brain barrier.

Metabolism: Metabolized in the liver, primarily by CYP1A2.

Excretion: Excreted mainly via the kidneys.

Half Life: 3-7 hours in neonates, shorter in older children and adults.

Contraindications

  • Known hypersensitivity to caffeine or other xanthines.

Precautions

  • Use cautiously in infants with cardiac arrhythmias, seizure disorders, or hepatic impairment. Monitor serum levels in prolonged use.

Adverse Reactions - Common

  • Insomnia (Common)
  • Increased heart rate (Common)
  • Gastrointestinal upset (Less common)

Adverse Reactions - Serious

  • Arrhythmias (Rare)
  • Seizures (Rare)

Drug-Drug Interactions

  • Certain antibiotics (e.g., ciprofloxacin) may increase caffeine levels.
  • Sympathomimetic agents may potentiate cardiovascular effects.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor respiratory status, heart rate, and serum caffeine levels if applicable.

Diagnoses:

  • Risk for impaired gas exchange
  • Ineffective breathing pattern

Implementation: Administer IV slowly, monitor for adverse reactions and efficacy, especially in neonates.

Evaluation: Assess for resolution of apnea episodes, monitor for adverse effects.

Patient/Family Teaching

  • Inform caregivers about potential side effects such as irritability or feeding difficulties.
  • Advise on the importance of monitoring for jitteriness or unconventional breathing patterns.

Special Considerations

Black Box Warnings:

  • Use with caution due to potential for toxicity; overdose can cause serious cardiac and neurological effects.

Genetic Factors: Some individuals may metabolize caffeine faster or slower depending on genetic factors affecting CYP1A2.

Lab Test Interference: May interfere with certain clinical laboratory tests, including serum catecholamine levels.

Overdose Management

Signs/Symptoms: Seizures, cardiac arrhythmias, severe caffeine intoxication including hyperactivity, tremors, vomiting.

Treatment: Supportive care, activated charcoal if ingestion recent, monitoring and managing arrhythmias, seizure control as needed.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.