Backcountry asthma and coffee

[kellymoe]

I was recently reading Bill Burke's little article in Rovers North Catalog about backcountry emergencies when I recalled a bit of info mentioned in passing during paramedic school over 20 years ago. As an avid coffee drinker I remember perking up when the instructor said caffeine had some properties similar to epinephrine, one of the first line of medications we use for asthma attacks in the field along with albuterol in a nebulized or mist form.
This got me thinking about uses of coffee in the case of an onset of mild to moderate asthma. Several clinical studies have found that at the onset of an asthmatic attack a cup or two of strong coffee helps open airways in much the same way epinephrine does but to a lesser extent.

This in no way should be a relied on treatment but if you or someone in your group begins to feel the onset of an asthma attack or have been stung by a bee or feel an anaphylactic reaction coming on and you forgot your epi pen or asthma meds, a good strong cup of joe just might help bridge the gap while you seek appropriate medical care.

 

[xcmountain80]

So would Mountain Dew, Red Bull, Monster, etc. be good for coping while proffesional help is sought.

Aaron

 

[kellymoe]

I would think anything with high caffeine content would help. All the studies I have read dealt with coffee. Maybe because it did not introduce other things such as sugar and niacin which is included in many energy drinks. I dont know how niacin, ghurana, or other additives effect the properties of caffeine.

Personally I would stick with plain old coffee.

 

[kjp1969]

A cup of strong coffee has something like 150mg of caffeine, where the same amount of soda has around 25mg. A huge starbucks has something like 300mg.

 

[DaveInDenver]

An 8 oz Redbull has about 75 mg of caffeine, 12 oz Mt Dew about 55mg. A 2 oz espresso has about 100 mg of caffeine and a an 8 oz cup of drip coffee has that roughly 150 mg kjp1969 mentioned. Most recommendations are to avoid refined sugar and artificial sweeteners as much as possible with asthma, so I think black coffee would be much preferred here.

 

[kellymoe]

Most recommendations are to avoid refined sugar and artificial sweeteners as much as possible with asthma, so I think black coffee would be much preferred here.

Good advice. I may be wrong but sugar seems to produce mucus which you would want to avoid in a asthma situation.

 

[bigreen505]

Most recommendations are to avoid refined sugar and artificial sweeteners as much as possible with asthma, so I think black coffee would be much preferred here.

You would think, but my experience has been somewhat different. For what it's worth, I have exercise induced asthma, allergies and cannot function in heat. Several years ago, I discovered quite by accident that drinking a Red Bull right before light air regatta (the kind where you bake and bob around the lake) helped me handle the heat better and in big breeze and capsizes I wouldn't get quite as winded. In both cases this was combined with an Albuterol inhaler.

Clearly there is something in there besides just the caffeine that is causing this. I would frequently have coffee before races and never noticed any real difference with and without.

On several cases I would combine a cup of coffee with ibuprofen and tylenol when Excedrin Migraine was not available, and that worked well, but Red Bull did not.

 

[Mc Taco]

Could you put a pinch of grounds between your cheek and gum? Only half kidding.

 

[xcmountain80]

Hmm something to consider but I always have coffee rarely have energy drink in the truck (unless it's an all night-er type of drive).

Aaron

 

[dakdoc]

I was recently reading Bill Burke's little article in Rovers North Catalog about backcountry emergencies when I recalled a bit of info mentioned in passing during paramedic school over 20 years ago. As an avid coffee drinker I remember perking up when the instructor said caffeine had some properties similar to epinephrine, one of the first line of medications we use for asthma attacks in the field along with albuterol in a nebulized or mist form.
This got me thinking about uses of coffee in the case of an onset of mild to moderate asthma. Several clinical studies have found that at the onset of an asthmatic attack a cup or two of strong coffee helps open airways in much the same way epinephrine does but to a lesser extent.

This in no way should be a relied on treatment but if you or someone in your group begins to feel the onset of an asthma attack or have been stung by a bee or feel an anaphylactic reaction coming on and you forgot your epi pen or asthma meds, a good strong cup of joe just might help bridge the gap while you seek appropriate medical care.

I think it's important to stress that epinephrine is not a first line therapy for asthma, neither in the back country nor in the hospital setting. Epinephrine is sometimes used as a last resort to bridge the gap just prior to intubation, however it is not a "first line therapy" and to my knowledge, never has been. Although many medics are interested in carrying epinephrine in the form of auto injectors, if used in the wrong clinical circumstances it can be quite dangerous. If you happen across a person who's having an allergic reaction and posesses his/her own epinephrine auto injector, it's probably fine to help that person administer the medication, however you should be very careful if administering your own epinephrine to a stranger, or if using one group member's auto injector on another person. The Good Samaritan Laws are vague and if something bad happens, you've now just been practicing medicine without a license. Even physicians and licensed medical practitioners must be careful in this respect, as the ability to practice medicine is something that is granted by states, and a physician licensed to practice medicine in one state may not be licensed to practice medicine while in another state on some sort of back country adventure. Different countries are a whole other topic.

That being said, caffiene has properties similar to theophyline, a methylxanthine which was previously used to treat asthma before the advent of albuterol. It inhibits an enzyme called phosphodiesterase and one of its side effects is bronchodilation. It's present in trace amounts in tea and cocoa, however it's generally in very subtherapeutic amounts. Epinephrine on the other hand, is a catecholamine which stimulates the adrenergic system, leading to increased heart rate, bronchodilation, and increased cardiac output.' I don't think the two are related.

Personally, I think if you have someone who's so sick and having so much trouble breathing that they're on the verge of respiratory collapse, administering them a large glass of tea or soda or red bull in effort to cause bronchodilation is the absolute last thing you should do. As kellymoe mentioned, however, there's probably no contraindication to a cup of coffee in the case of mild-moderate asthma.

Jon

 

[HOOLIGAN]

I've also seen cases of patients becoming very tachycardia and tachypneic after drinking 4 or 5 red bulls in a relatively short amount of time. If you look at the caffeine levels posted above, thats the equivalent of 2 to 3 cups of coffee. These folks anxiety levels were also through the roof. Not exactly a situation I'd want to put someone in when having a severe asthma attack.


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