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1. restlessness
2. nervousness
3. excitement
4. insomnia
5. flushed face
6. diuresis
7. gastrointestinal disturbance
8. muscle twitching
9. rambling flow of thought and speech
10. tachycardia or cardiac arrhythmia
11. periods of inexhaustibility
12. psychomotor agitation
3. Not due to any physical or other mental disorder, such
as an Anxiety Disorder.
Basically, overdosing on caffeine will probably be very very
unpleasant but not kill or deliver permanent damage. However, People
do die from it.
Toxic dose
The LD_50 of caffeine (that is the lethal dosage reported to kill
50% of the population) is estimated at 10 grams for oral
administration. As it is usually the case, lethal dosage varies
from individual to individual according to weight. Ingestion of
150mg/kg of caffeine seems to be the LD_50 for all people. That
is, people weighting 50 kilos have an LD_50 of approx. 7.5 grams,
people weighting 80 kilos have an LD_50 of about 12 grams.
In cups of coffee the LD_50 varies from 50 to 200 cups of coffee
or about 50 vivarins (200mg each).
One exceptional case documents survival after ingesting 24 grams.
The minimum lethal dose ever reported was 3.2 grams
intravenously, this does not represent the oral MLD (minimum
lethal dose).
In small children ingestion of 35 mg/kg can lead to moderate
toxicity. The amount of caffeine in an average cup of coffee is
50 - 200 mg. Infants metabolize caffeine very slowly.
Symptoms
+ Acute caffeine poisoning gives early symptoms of anorexia,
tremor, and restlessness. Followed by nausea, vomiting,
tachycardia, and confusion. Serious intoxication may cause
delirium, seizures, supraventricular and ventricular
tachyarrhythmias, hypokalemia, and hyperglycemia.
+ Chronic high-dose caffeine intake can lead to nervousness,
irritability, anxiety, tremulousness, muscle twitching,
insomnia, palpitations and hyperreflexia. For blood testing,
cross-reaction with theophylline assays will detect toxic
amounts. (Method IA) Blood concentration of 1-10 mg/L is
normal in coffee drinkers, while 80 mg/L has been associated
with death.
Treatment
+ Emergency Measures
+ Maintain the airway and assist ventilation. (See
Appendix A)
+ Treat seizures & hypotension if they occur.
+ Hypokalemia usually goes away by itself.
+ Monitor Vital Signs.
+
+ Specific drugs & antidotes. Beta blockers effectively
reverse cardiotoxic effects mediated by excessive
beta-adrenergic stimulation. Treat hypotension or
tachyarrhythmias with intravenous propanolol, .01 - .02
mg/kg. , or esmolol, .05 mg/kg , carefully titrated with low
doses. Esmolol is preferred because of its short half life
and low cardioselectivity.
+ Decontamination
+ Induce vomiting or perform gastric lavage.
+ Administer activated charcoal and cathartic.
+ Gut emptying is probably not needed if 1 2 are
performed promptly.
Appendix A
Performing airway assistance.
1. If no neck injury is suspected, place in the "Sniffing"
position by tilting the head back and extending the front of
the neck.
2. Apply the "Jaw Thrust" to move the tongue out of the way
without flexing the neck: Place thumb fingers from both
hands under the back of the jaw and thrust the jaw forward
so that the chin sticks out. This should also hurt the
patient, allowing you to judge depth of coma. :)
3. Tilt the head to the side to allow vomit and snot to drain
out.
From conversations on alt.drugs.caffeine:
The toxic dose is going to vary from person to person, depending
primarily on built-up tolerance. A couple people report swallowing 10
to 13 vivarin and ending up in the hospital with their stomaches
pumped, while a few say they've taken that many and barely stayed
awake.
A symptom lacking in the clinical manual but reported by at least two
people on the net is a loss of motor ability: inability to move,
speak, or even blink. The experience is consistently described as very
unpleasant and not fun at all, even by those very familiar with
caffeine nausea and headaches.
3. Effects of caffeine on pregnant women.
Caffeine has long been suspect of causing mal-formations in fetus, and
that it may reduce fertility rates.
These reports have proved controversial. What is known is that
caffeine does causes malformations in rats, when ingested at rates
comparable to 70 cups a day for humans. Many other species respond
equally to such large amounts of caffeine.
Data is scant, as experimentation on humans is not feasible. In any
case moderation in caffeine ingestion seems to be a prudent course for
pregnant women. Recent references are Pastore and Savitz, Case-control
study of caffeinated beverages and preterm delivery. American Journal
of Epidemiology, Jan 1995.
On men, it has been shown that caffeine reduces rates of sperm
motility which may account for some findings of reduced fertility.
4. Caffeine and Osteoporosis (Calcium loss)
From the Journal of AMA: (JAMA, 26 Jan. 1994, p. 280-3.)
"There was a significant association between (drinking more)
caffeinated coffee and decreasing bone mineral density at both the hip
and the spine, independent of age, obesity, years since menopause, and
the use of tobacco, estrogen, alcohol, thiazides, and calcium
supplements [in women]."
Except when:
"Bone density did not vary [...] in women who reported drinking at
least one glass of milk per day during most of their adult lives."
That is, if you drink a glass of milk a day, there is no need to worry
about the caffeine related loss of calcium.
5. Studies on the side-effects of caffeine.
OAKLAND, California (UPI) -- Coffee may be good for life. A major
study has found fewer suicides among coffee drinkers than those who
abstained from the hot black brew.
The study of nearly 130,000 Northern California residents and the
records of 4,500 who have died looked at the effects of coffee and tea
on mortality.
Cardiologist Arthur Klatsky said of the surprising results, ``This is
not a fluke finding because our study was very large, involved a
multiracial population, men, women, and examined closely numerous
factors related to mortality such as alcohol consumption and
smoking.''
The unique survey also found no link between coffee consumption and
death risk. And it confirmed a ``weak'' connection of coffee or tea to
heart attack risk -- but not to other cardiovascular conditions such
as stroke.
The study was conducted by the health maintenance organization Kaiser
Permanente and was reported Wednesday in the Annals of Epidemiology.
6. Caffeine and depression.
7. Caffeine and your metabolism.
Caffeine increases the level of circulating fatty acids. This has been
shown to increase the oxidation of these fuels, hence enhancing fat
oxidation. Caffeine has been used for years by runners and endurance
people to enhance fatty acid metabolism. It's particularly effective
in those who are not habitual users.
Caffeine is not an appetite suppressant. It does affect metabolism,
though it is a good question whether its use truly makes any
difference during a diet. The questionable rationale for its original
inclusion in diet pills was to make a poor man's amphetamine-like
preparation from the non-stimulant sympathomimetic phenylpropanolamine
and the stimulant caffeine. (That you end up with something very
non-amphetamine like is neither here nor there.) The combination drugs
were called "Dexatrim" or Dexa-whosis (as in Dexedrine) for a reason,
namely, to assert its similarity in the minds of prospective buyers.
However, caffeine has not been in OTC diet pills for many years per
order of the FDA, which stated that there was no evidence of efficacy
for such a combination.
From Goodman and Gilman's The Pharmacological Basis of Therapeutics:
Caffeine in combination with an analgesic, such as aspirin,
is widely used in the treatment of ordinary types of
headache. There are few data to substantiate its efficacy
for this purpose. Caffeine is also used in combination with
an ergot alkaloid in the treatment of migrane (Chapter 39).
Ergotamine is usually administered orally (in combination
with caffeine) or sublingually [...] If a patient cannot
tolerate ergotamine orally, rectal administration of a
mixture of caffeine and ergotamine tartarate may be
attempted.
The bioavailability [of ergotamine] after sublingual
administration is also poor and is often inadequate for
therapeutic purposes [...] the concurrent administration of
caffeine (50-100 mg per mg of ergotamine) improves both the
rate and extent of absorption [...] However, there is little
correspondence between the concentration of ergotamine in
plasma and the intensity or duration of therapeutic or toxic
effects.
Caffeine enhances the action of the ergot alkaloids in the
treatment of migrane, a discovery that must be credited to
the sufferers from the disease who observed that strong
coffee gave symptomatic relief, especially when combined
with the ergot alkaloids. As mentioned, caffeine increases
the oral and rectal absorption of ergotamine, and it is
widely believed that this accounts for its enhancement of
therapeutic effects.
Nowadays most of researchers believe that the stimulatory actions are
attributable to the antagonism of the adenosine. Agonists at the
adenosine receptors produce sedation while antagonists at these sites,
like caffeine and theophylline induce stimulation, and what is even
more important, the latter substance also reverse agonists-induced
symptoms of sedation, thus indicating that this effects go through
these receptors.
Another possibility, however, is that methylxanthines enhance release
of excitatory aminoacids, like glutamate and aspartate, which are the
main stimulatory neurotransmitters in the brain.
As to the side effects: methylxanthines inhibit protective activity of
common antiepileptic drugs in exptl. animals in doses comparable to
those used in humans when correction to the surface area is made. It
should be underlined, that although tolerance develop to the
stimulatory effects of theo or caffeine when administered on a chronic
base, we found no tolerance to the above effects . This hazardous
influence was even enhanced over time. Therefore, it should be
emphasized that individuals suffering from epilepsy should avoid, or
at least reduce consumption of coffee and other caffeine-containing
beverages.
* Miscellaneous
1. How do you pronounce mate?
MAH-teh. MAH like in malt, and -teh like in Gral. Patten.
2. How do you spell Colombia/Colombian?
3. How do you spell Espresso?
By far, the most common spelling used throughout the world today is
"espresso". This is a shortened form of the original Italian name for
the drink "caffe espresso" (accent marks omitted). This spelling is
considered to be the correct spelling by the vast majority of of
coffee consumers, vendors, retailers, and producers.
Some English language dictionaries also list "expresso" as a variant
spelling. However, this does not mean the spelling is 'equally valid'.
(see the post by Jesse Sheidlower included below)
It was pointed out during the great "espresso vs. expresso" debate
(spring 94) that the Italian alphabet does not even contain the letter
"X", which is incorrect.
Further, it was discovered that at least three dictionaries contained
incorrect definitions of the word "espresso". The American Heritage
Dictionary gave the following definition:
"A strong coffee brewed by forcing steam under pressure
through darkly roasted, powdered coffee beans."
The Oxford English Dictionary said:
"Coffee brewed by forcing steam through powdered coffee
beans"
The Webster New World Dictionary gives:
"coffee prepared in a special machine from finely ground
coffee beans, through which steam under high pressure is
forced."
All three of these are wrong. In fact, espresso is a strong coffee
brewed by quickly forcing hot water through darkly roasted, finely
ground coffee beans.
(Some espresso makers do use steam, but only to force the hot water
through the ground coffee. The steam NEVER touches the coffee. Many
espresso makers use no steam at all. Instead, they use either a pump
or a piston to quickly force hot water through the ground coffee.)
Once these errors and the origins of the word "espresso" had been
pointed out, the argument "but expresso is in the dictionary" quickly
began to crumble. The final death blow to this position came in a post
by dictionary editor Jesse Sheidlower. This post is reproduced in its
entirety below:
Jesse Sheidlower writes
I find this thread fascinating. I regret that it
demonstrates an unfamiliarity with dictionaries and how to
use them, but no matter. I believe that I am the only
dictionary editor to participate in this discussion, so let
me waste a bit more bandwidth addressing some of the points
made so far, and introducing a few others:
o The OED, Second Edition, does include _espresso_ and
_expresso_, the latter being a variant of the former.
It correctly derives it from Italian _caffe espresso_.
[Accents left off here.] Whoever claimed it derives the
term from a would-be Italian _caffe expresso_ was in
error.
o There _is_ an "x" in Latin and Italian.
Mike Oliver points out that there are two italian
alphabets, one (il tradizionale) with no w, x or y, and
the other one with all the letters in the english
alphabet. The latter seems to be the one currently in
use. (Reference: Il grande dizionario Garzanti della
lingua italiana, Garzanti Editore s.p.a, 1987).
o There are four major American dictionaries (published
by Merriam Webster, Webster's New World, Random House,
and American Heritage). The most recent edition of each
gives _espresso_ as the main form, and _expresso_ as a
variant only. The fact that _expresso_ is listed in the
dictionary does not mean that it is equally common: the
front matter for each dictionary explains this. The
person who claimed that three dictionaries including
OED give _expresso_ as "equally valid" was in error.
o Dictionaries, in general, do not dictate usage: they
reflect the usage that exists in the language. If a
dictionary says that _espresso_ is the main spelling,
it means that in the experience of its editors (based
on an examination of the language), _espresso_ is
notably more common. It does not mean that the editors
have a vendetta against _expresso_.
o To the linguist who rejects the authority of
dictionaries: I agree that language is constantly
changing; I'm sure that every dictionary editor in the
country does as well. Dictionaries are outdated before
they go to press. But I think they remain accurate to a
large extent. Also, if you are going to disagree with
the conclusions of a dictionary, you should be prepared
to back yourself up. I can defend, with extensive
written evidence, our decision to give _espresso_ as
the preferred form.
o The spelling _espresso_ is the form used by the copy
desks of the _New York Times,_ _Gourmet,_ _Bon
Appetit,_ The _Wine Spectator,_ the _Wall St. Journal,_
the _L.A. Times,_ _Time,_ _Newsweek,_ and to my
knowledge every other major or minor newspaper or
magazine, general or food-related, in the
English-speaking world. The fact that a handwritten
menu on an Italian restaurant door spells it "expresso"
is trivial by comparison.
o In sum: though both _espresso_ and _expresso_ are
found, the former is by far the more common. It is also
to be favored on immediate etymological evidence, since
the Italian word from which it is directly borrowed is
spelled _espresso_. The form _espresso_ is clearly
preferred by all mainstream sources.
4. Where did the term "cup of joe" come from?
Legend has it that the origin is a follows
The U.S. Navy used to serve alcoholic beverages on board ships.
However, when Admiral Josephus "Joe" Daniels became Chief of Naval
Operations, he outlawed alcohol onboard ships, except for very special
occasions. Coffee then became the beverage of choice, hence the term
"Cup of Joe."
* Coffee Recipes and other beverages.
1. Espresso
After living in Italy (Rome) for two years and living off espresso,
Mr. X have found American espresso doesn't cut it. Heres how to do it.
o Get good dark roasted espresso beans, imported Italian brand if
you can find it.
o Pack your strainer real full. Pack it hard. your instructions
will say NOT to pack it, but don't listen.
o Don't use too much water. Espresso in Italy is as thick as syrup.
Very thick.
o Add two spoons of sugar, it's a sweet, thick liquid in Italy.
Drink fast.
Enjoy.
If using a stove top espresso machine, clean after each use, paying
attention to the seal and strainer.
1. For best results, get arabica beans that have been roasted dark
("Italian Roast" is darkest) and are oily-looking. Other roasts
are for other types of brewing: espresso machines won't draw the
earthy flavour of Sumatran out, for example. A small amount of
other beans might add a nice note to the flavour, though (I've
had surprising success adding a few of Thanksgiving Coffee's
"High-Caffeine Pony Express" beans, which are actually robusta
beans from Thailand).
2. Grind those beans until they're very fine, but not quite a
powder. Put them into the appropriate piece of your machine and
tamp it down (but don't pack all the grounds in tight).
3. Watch the espresso as it drips down. Does a nice layer of foam
form on the top? If it does, all is well; that foam is made from
the flavourful oils, and it is called crema. If not, go to the
coffee roaster and demand quadruple your money back.
4. Never make more than 2oz at a time. If you're making two cups of
espresso, make two separate shots. This is important. The idea is
that the water rushes through and draws out only the most
flavourful part of the grounds. More than 2oz and you're drawing
out less flavourful stuff and diluting your espresso. If you're
really hardcore, make only 1oz at a time; this is called caffe
ristretto.
2. Chocolate covered espresso beans
You won't get single, glossy beans, but the taste is there!
1. Put dark roast coffee beans on a waxpaper-covered baking sheet.
2. Melt some chocolate by puting a container with the chocolate in a
pan of boiling water, stir the chocolate when it is getting hot.
Some experimentation regarding what chocolate to use is in place.
I used chocolate chips of from Girardelli. One should probably
aim for dark and not too sweet chocolate.
3. Pour the chocolate over the beans and smear it so that each bean
is covered - you should have a single layer of covered beans not
too far apart.
4. When the beans have cooled off a little bit, put the sheet in the
fridge/freezer.
5. When solid, break off a piece and enjoy.
3. Cappuccino
Disclaimer: People prepare cappuccino in many different ways, and in
their very own way each one of them is correct. The following recipe,
which is commonly used in Latin countries, has been tasted by several
of my North-American friends and they unanimously agreed that
cappuccino prepared using this recipe tastes much better than the
standard fare in USA/Canada.
Start with cold milk (it doesn't really need to be ice-cold), use homo
milk or carnation. 2% or skim is just not thick enough (admittedly, it
is easier to produce foam with skim milk).
Place the milk on a special cappuccino glass with a cappuccino basket.
(Cappuccino glasses have a thinner bottom).
Aerate the milk near the top, within 2cm (1 in) of the top. Move the
glass down as the milk aerates. It is a good idea to have an
oscillating motion while aerating the milk.
Aerating the milk in another container, then pouring in a glass and
adding the foam with a spoon is sacrilege.
Anybody who has done so should make a pilgrimage to San Francisco's
Girardelli's. Otherwise entry to heaven will be denied (god, is after
all, Italian. At least the catholic one).
If you need to aerate the milk on a separate container, aerate exactly
the amount of milk required for one cup, so no need to add foam with a
spoon.
Once the milk has been aerated, promptly clean the aerator with a wet
rag. Failure to do so will quickly result in rotten milk flavour
coming from the aerator.
Another warning on similar lines applies to restaurant type coffee
machines: leave the aerator valve open when powering the machine up
and down. When the machine is off a partial vacuum is formed in the
boiler that will suck milk residue into the boiler. This then coats
the inside of the boiler and can cause bad smelling steam until the
boiler is flushed. Some machines have a vacuum bleed valve to prevent
this problem but many don't.
Wait for the steam pressure to build up again (for some cappuccino
makers wait time is near zero, for others it maybe as long as 60
secs).
Prepare the espresso coffee, you may add it directly on to the glass
if possible or use a cup and then pour it from the cup on the milk.
According to Jym Dyer: In Italy, the milk is added TO the espresso,
not the other way around, that way the milk is floating; on top, where
you then add the sugar, and stir it up.
Cappuccino tastes better when is really hot, and has two teaspoons of
sugar. (small teaspoons, like the ones in expensive silverware).
Then accompany said cappuccino with a warm tea bisquet or english
muffin with marmalade, or alternatively with a baguette sandwich or
panini.
4. Frappe
Frappe coffee is widely consumed in parts of Europe and LatinAmerica
especially in summer. Originally was made with cold espresso. Nowadays
is prepared in most places by shaking into a shaker 1-2 teaspoons of
instant coffee with sugar, water and ice-cubes and it is served in a
long glass with ice, milk to taste and a straw. The important thing is
the thick froth on top of the glass.
5. How to make your own chocolate
Here's the recipe for making a real chocolate beverage. Important
steps are in boldface.
Ingredients
o 1-2kg (2-4pounds) of cocoa beans.
o A manually operated grinder.
Instructions
o Sift through the beans removing any impurities (pieces of grass,
leaves, etc).
o Place the beans in a pan (no teflon) and roast them. Stir
frequently. As the beans roast they start making "pop" sounds
like popcorn. Beans are ready when you estimate that approx
50-75% of the beans have popped. Do not let the beans burn,
though a bit of black on each bean is ok.
o Peel the beans. Peeling roasted cocoa beans is like peeling baked
potatoes: The hotter they are the easier it is to peel the darn
things, at the expense of third degree burns on your fingers.
(Tip: Use kitchen mittens and brush the beans in your hands). If
the beans are too hard to peel roast them a bit longer.
o Grind the beans into a pan. They produce a dark oily paste called
"cocoa paste".
o The oil in the cocoa has a bitter taste that you have to get used
to. I like it this way, but not all people do. Here are the
alternatives:
With oil, which gives you a richer flavour:
Spread aluminum foil on a table and make small pies of chocolate,
about 1/4 of an inch high, and 6 inches in diameter. Let them
rest overnight. The morning after they are hard tablets. Remove
them from the aluminum foil and rap them in it. Store in the
freezer.
Without oil, some flavour is gone, less bitter, weaker (whimper)
chocolate:
Put the paste inside a thin cloth (like linen), close the cloth
and squeeze until the oil comes out. If you manage to get most of
the oil out, what is left is high quality cocoa powder, like
Droste's.
What is left now is either bitter tablets or bitter cocoa powder.
You can now make a nice beverage as follows:
o Boil a liter of milk (or water, like in ancient Mexican style.
Like water for chocolate, "Como agua para chocolate": you know).
o When the milk is warm (not hot) add a chocolate pie in pieces.
Stir with a blender (but be careful! the blender's electric cord
should NOT touch the pot or any other hot thing around it).
o When the chocolate has dissolved add 1/2-3/4 cups of sugar
(depending how sweet you like your chocolate) and blend in fast.
Make sure the sugar is completely dissolved in the chocolate
otherwise it would be bitter no matter how much sugar you may add
afterwards.
o Add a teaspoon of cinnamon or natural vanilla flavour (artificial
vanilla flavour with chocolate results in an awful medicine like
flavour) if you like, and blend again.
o Let the mixture boil, when it starts to get bubbly quickly remove
the pan from the stove top, and rest the bottom against a soaked
cloth. Put again on stove top, it should get bubbly almost
immediately, remove once again and repeat one last time. This
aerates the chocolate which enhances flavour.
o In a mug, put about 1/2-3/4 of the chocolate mixture, and add
cold milk, until the temperature and/or the concentration of the
flavour is right for your tastes. Accompany with French Pastries.
Yum Yum!!
Enjoy!
6. How to make the best cup of coffee?
The best coffee I ever tasted was while in the coffee growing regions
of Mexico, in the state of Veracruz, in the town of Coatepec. The
quality of the coffee was mostly due to the method of preparation than
to the quality of the grains (which is at about the same level as an
average colombian coffee). Here's how to make it:
o Grind the coffee grains from coarse to very coarse.
o Boil in a pan a litre of water (four cups).
o When the water is boiling, turn off the stove and add 8-12 table
spoons of coffee (2-3 spoons per each cup).
o Add two-three teaspoons of sugar per cup (for a total of 8-12
spoons of sugar).
o Stir very slowly (the water is so hot that the sugar dissolves
mostly on its own).
o Let the coffee rest for about 5 minutes.
o Strain the coffee using a metal strainer! Like the ones used for
cooking. The strainer should be like the ones used by granny for
making tea. The diameter is a bit smaller that a cup, with a
semi-sphere shape.
o This coffee has grit in the bottom, even after being strained.
Therefore do not stir the pot or the cup. If the coffee is
shaked, let it rest for about five minutes. Needless to say, do
not drink the last sip of coffee from the cup: it's all grit. If
you want to add milk, add carnation.
Warning: This coffee may fool you 'cause it has a very smooth taste
but is extremely strong. Caffeine content per millilitre is right
there with espresso, but you can't tell!
Note: For some strange reason, when preparing this coffee I tend to
have a success ratio of about one out of two attempts. I still don't
know what I'm doing wrong, since, as far as I can tell, always repeat
the same steps. Perhaps sometimes I don't let the coffee rest long
enough.
This type of coffee is similar in nature to the French press. And in
principle, you could possibly add sugar to the ground coffee, then
pour water, and lastly press with the strainer.
7. Turkish Coffee
Turkish coffee is prepared using a little copper pot called raqwa.
Use a heaping teaspoon of very finely ground coffee and, optionally,
one heaping teaspoon of sugar (to taste). Use about 3oz of coffee.
[Add the sugar only just before boiling point.] Turkish coffee without
sugar is called sade, with a little sugar is "orta s,ekerli" and with
lots of sugar is "c,ok s,ekerli".
The trick of it is to heat it until it froths pour the froth into the
coffee dup and heat it a second time. When it froths again, pour the
rest into the cup.
The grounds will settle to the bottom of the cup as you drink the
coffee and towards the end, it'll start to taste bitter and the
texture will be more like wet coffee grounds than a drink. As soon as
this happens stop or your next sip will taste really, really bitter.
Instead, turn your cup upside down on the saucer, and let someone read
your fortune!
8. Irish Coffee
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