Now you may be saying to yourself...how does caffeine help my breathing? Can you use caffeine in your respiratory distress patients?
No, this VETgirl online veterinary CE blog isn't about your Venti-Iced-Skinny-Hazelnut-Macchiato-Sugar-Free-Light-Ice coffee getting you through your day at the veterinary clinic. Rather, it's about the other medically legitimate uses of caffeine in veterinary medicine.
Caffeine is a medication that is in the class of drugs known as methylxanthines. Methylxanthines are competitive nonselective phosphodiesterase inhibitors, which raise intracellular cAMP, activate PKA, inhibit TNF-alpha and leukotriene synthesis, and reduce inflammation and innate immunity as well. Caffeine is also a nonselective adenosine receptor antagonist. In short, these compounds affect the airway, stimulate heart rate, increase force of muscular contraction, and have potential anti-inflammatory properties.
This is why many of us recognize methylxanthines as one of the common toxicants that we seen in our veterinary emergency room patients... chocolate! Methylxanthines are also found in toxins such as over the over-the-counter stimulant tablets (e.g., NoDoz), mulch, and asthma medications. While methylxanthines can be toxic, at the correct dose (and for the right patient), they can also be therapeutic. Certain dermatoses may be treated with pentoxifylline. Pentoxifylline is derived from theobromine and have some anti-inflammatory effects.
But getting back to caffeine, this too can be a beneficial methylxanthine for our patients. Methylxanthines medications such as aminophylline, theophylline, or caffeine can be used to improve oxygenation and pulmonary blood flow. In severe cases of respiratory distress (with suspected respiratory fatigue), caffeine can help strengthen diaphragmatic contractions and respiratory muscles. It is also thought to help stimulation of the respiratory center and increase minute ventilation.
So if you do have a severe, respiratory fatigue patient, remember how you feel when you have your Venti Iced Skinny Hazelnut Macchiato, Sugar-Free Syrup, Extra Shot, Light Ice, with Whip! While caffeine isn't commonly used in the emergency critical care setting, you may find your local criticalist reaching for it for your patients once in a while!