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IRRITABILITY and Tylenol

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IRRITABILITY Symptoms and Causes

What is caffeine?

Caffeine is a bitter substance that occurs naturally in more than 60 plants including

  • Coffee beans
  • Tea leaves
  • Kola nuts, which are used to flavor soft drink colas
  • Cacao pods, which are used to make chocolate products

There is also synthetic (man-made) caffeine, which is added to some medicines, foods, and drinks. For example, some pain relievers, cold medicines, and over-the-counter medicines for alertness contain synthetic caffeine. So do energy drinks and "energy-boosting" gums and snacks.

Most people consume caffeine from drinks. The amounts of caffeine in different drinks can vary a lot, but it is generally

  • An 8-ounce cup of coffee: 95-200 mg
  • A 12-ounce can of cola: 35-45 mg
  • An 8-ounce energy drink: 70-100 mg
  • An 8-ounce cup of tea: 14-60 mg
What are caffeine's effects on the body?

Caffeine has many effects on your body's metabolism. It

  • Stimulates your central nervous system, which can make you feel more awake and give you a boost of energy
  • Is a diuretic, meaning that it helps your body get rid of extra salt and water by urinating more
  • Increases the release of acid in your stomach, sometimes leading to an upset stomach or heartburn
  • May interfere with the absorption of calcium in the body
  • Increases your blood pressure

Within one hour of eating or drinking caffeine, it reaches its peak level in your blood. You may continue to feel the effects of caffeine for four to six hours.

What are the side effects from too much caffeine?

For most people, it is not harmful to consume up to 400mg of caffeine a day. If you do eat or drink too much caffeine, it can cause health problems, such as

  • Restlessness and shakiness
  • Insomnia
  • Headaches
  • Dizziness
  • Rapid or abnormal heart rhythm
  • Dehydration
  • Anxiety
  • Dependency, so you need to take more of it to get the same results

Some people are more sensitive to the effects of caffeine than others.

What are energy drinks, and why can they be a problem?

Energy drinks are beverages that have added caffeine. The amount of caffeine in energy drinks can vary widely, and sometimes the labels on the drinks do not give you the actual amount of caffeine in them. Energy drinks may also contain sugars, vitamins, herbs, and supplements.

Companies that make energy drinks claim that the drinks can increase alertness and improve physical and mental performance. This has helped make the drinks popular with American teens and young adults. There's limited data showing that energy drinks might temporarily improve alertness and physical endurance. There is not enough evidence to show that they enhance strength or power. But what we do know is that energy drinks can be dangerous because they have large amounts of caffeine. And since they have lots of sugar, they can contribute to weight gain and worsen diabetes.

Sometimes young people mix their energy drinks with alcohol. It is dangerous to combine alcohol and caffeine. Caffeine can interfere with your ability to recognize how drunk you are, which can lead you to drink more. This also makes you more likely to make bad decisions.

Who should avoid or limit caffeine?

You should check with your health care provider about whether you should limit or avoid caffeine if you

  • Are pregnant, since caffeine passes through the placenta to your baby
  • Are breastfeeding, since a small amount of caffeine that you consume is passed along to your baby
  • Have sleep disorders, including insomnia
  • Have migraines or other chronic headaches
  • Have anxiety
  • Have GERD or ulcers
  • Have fast or irregular heart rhythms
  • Have high blood pressure
  • Take certain medicines or supplements, including stimulants, certain antibiotics, asthma medicines, and heart medicines. Check with your health care provider about whether there might be interactions between caffeine and any medicines and supplements that you take.
  • Are a child or teen. Neither should have as much caffeine as adults. Children can be especially sensitive to the effects of caffeine.
What is caffeine withdrawal?

If you have been consuming caffeine on a regular basis and then suddenly stop, you may have caffeine withdrawal. Symptoms can include

  • Headaches
  • Drowsiness
  • Irritability
  • Nausea
  • Difficulty concentrating

These symptoms usually go away after a couple of days.

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IRRITABILITY Clinical Trials and Studies

Treatments might be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. The goal of clinical trials is to determine if a new test or treatment works and is safe. Clinical trials can also look at other aspects of care, such as improving the quality of life for people with chronic illnesses. People participate in clinical trials for a variety of reasons. Healthy volunteers say they participate to help others and to contribute to moving science forward. Participants with an illness or disease also participate to help others, but also to possibly receive the newest treatment and to have the additional care and attention from the clinical trial staff.
Rank Status Study
1 Unknown  Analgesic Effect of Paracetamol, Paracetamol + Codeine, Ibuprofen and Their Combination
Condition: Pain, Postoperative
Interventions: Drug: Ibuprofen + Paracetamol;   Drug: Ibuprofen + Paracetamol + Codeine;   Drug: Paracetamol + Codeine;   Drug: Placebo
Outcome Measures: Sum pain intensity SPI (0-10 Numerical Rating Scale);   Sum pain intensity difference score (PID);   Overall assessment of efficacy (4-point Verbal Rating Scale);   Adverse effects AE (Specific reporting of AE - type, duration and severity)
2 Not yet recruiting Equality Study of Ofirmev vs Oral Acetaminophen
Condition: Pain, Postoperative
Interventions: Drug: IV acetaminophen;   Drug: oral acetaminophen
Outcome Measures: Primary outcome will measure total opioid consumption while the patient is in the PACU;   time from PACU admission to request for first opioid dose
3 Unknown  Acetaminophen for Cancer Pain
Conditions: Cancer;   Pain
Interventions: Drug: Acetaminophen;   Drug: acetaminophen;   Drug: placebo, sugar pill
Outcome Measures: Patient preference for the acetaminophen or the placebo arm as assessed by asking the patient whether he/she preferred treatment period 1 or treatment period 2;   Differences in the mean pain intensity score as assessed by the daily average Numeric Rating Scale (NRS) pain score during the week given acetaminophen compared with the daily average NRS pain score during the week given placebo;   Symptoms possibly associated with acetaminophen use for each period using an NRS: feeling sick (nausea and vomiting);   drowsiness;   constipation;   cold sweats;   overall sense of well being;   Total analgesic consumption in each treatment period;   Best and worst pain scores for each treatment period;   Pain relief obtained in each treatment period;   Effect of pain on functional ability;   Strength of preference for acetaminophen versus placebo on a 5-point scale;   Proportion of patients who had a preference for acetaminophen who perceived the improvement warranted taking the additional tablets;   Proportion of patients having a clinically significant improvement in pain (defined as an improvement in mean NRS of at least 33% during the week taking acetaminophen)
4 Recruiting Intraoperative and Post-operative Analgesic Effect of IV Acetaminophen for Sinus Surgery
Condition: Chronic Sinusitis
Interventions: Drug: IV Acetaminophen;   Drug: Placebo
Outcome Measures: Assess the efficacy of IV acetaminophen in controlling postoperative pain;   Investigate the effect of IV acetaminophen on the use of postoperative opioid analgesics;   Analyze effects of IV acetaminophen on intraoperative analgesic use;   Identify potential correlation between vital signs and postoperative pain intensity;   Examine the effect of IV acetaminophen on post-operative quality of recovery
5 Recruiting Paracetamol (Acetaminophen) for Closure of PDA in Preterm Infants
Condition: PDA
Interventions: Drug: Paracetamol;   Drug: Ibuprofen;   Procedure: Closure of PDA
Outcome Measures: Closure of arterial duct - yes / No;   Need for surgical closure of arterial duct
6 Recruiting Paracetamol Effect on Oxidative Stress and Renal Function in Severe Malaria
Condition: Malaria
Interventions: Drug: Paracetamol;   Drug: No Paracetamol
Outcome Measures: Effect of paracetamol concentrations;   Compare treatment arm with control arm with respect to duration of Acute Kidney Injury (AKI) and development of AKI.;   Oxidative stress assessed by measuring F2-isoprostanes (F2-IsoPs);   Assessment of Blackwater fever;   Mortality trends;   Intravascular Haemolysis;   Fever clearance time;   Parasite clearance time;   Parasite sequestration;   Assessment of Acute Kidney Injury;   Creatinine clearance;   Safety assessment
7 Recruiting Slow Initial β-lactam Infusion With High-dose Paracetamol to Improve the Outcomes of Childhood Bacterial Meningitis
Condition: Bacterial Meningitis
Interventions: Drug: Infusion with paracetamol;   Drug: Bolus without paracetamol
Outcome Measures: Mortality;   Status on the modified Glasgow Outcome Scale;   Death or any sequelae;   A change in hearing threshold compared to the first test result;   Death or severe neurological sequelae;   Deafness
8 Unknown  Paracetamol for Cancer Pain
Conditions: Advanced Cancer;   Opioid Use, Unspecified
Interventions: Drug: paracetamol;   Drug: placebo tablets
Outcome Measures: Pain reduction caused by paracetamol 4g/d;   Overall satisfaction with the pain treatment
9 Recruiting Clinical Study Comparing the Efficacy of Transbuccal Paracetamol 125 mg Versus Paracetamol Injection 1g in Slow Infusion IV in Patients With Acute Pain
Condition: Acute Pain
Interventions: Drug: paracetamol;   Drug: Placebo
Outcome Measure: Pain score measured by visual analogue scale
10 Unknown  The Effect of Single Dose Paracetamol on the Lower Airways of Asthmatic and Healthy Children
Condition: Asthma
Intervention: Drug: paracetamol
Outcome Measure: A measurable change in lung functions in response to paracetamol exposure.
11 Recruiting Prospective, Randomized, Double Blind Study Comparing IV vs PO Acetaminophen in Patients Undergoing Lumbar Discectomy
Condition: Pain
Interventions: Drug: oral acetaminophen;   Drug: intravenous acetaminophen
Outcome Measures: Postoperative pain scores;   Quantity of intraoperative and postoperative opioids administered.
12 Recruiting Can Acetaminophen Given 1-2 Hours to Children Before Ear Tube Surgery Reduce Agitation After Anesthesia?
Conditions: Emergence Agitation;   Pain
Intervention: Drug: Acetaminophen
Outcome Measures: Emergence Agitation;   Pain
13 Recruiting Analgesic Efficacy of Intravenous Acetaminophen After Video-assisted Thoracic Surgery
Condition: Video-assisted Thoracic Surgery
Interventions: Drug: IV Acetaminophen;   Drug: Saline Placebo
Outcome Measures: Total morphine consumption;   Number of PCA morphine bolus requests;   Pain Scores;   Vital signs
14 Recruiting A Prospective, Randomized, Double Blind, Comparative-effectiveness Study Comparing Perioperative Administration of Oral Versus Intravenous Acetaminophen for Laparoscopic Cholecystectomy
Condition: Laparoscopic Cholecystectomy
Interventions: Drug: 2 capsules Oral Tylenol 2000 mg and IV "salt water";   Drug: IV Tylenol 1000mg and 2 oral capsule "sugar pills"
Outcome Measures: Pain;   Opioid Use
15 Not yet recruiting Adding Paracetamol to Ibuprofen for Treatment of Patent Ductus Arteriosus in Preterm Infants
Condition: Hemodynamically Significant Patent Ductus Arteriosus in Preterm Infants
Interventions: Drug: Paracetamol;   Drug: Placebo
Outcome Measures: The incidence of patent ductus arteriosus closure;   The need for surgical ligation for PDA;   Adverse effects
16 Recruiting Intravenous Acetaminophen for Non-Narcotic Postoperative Pain Management Following Knee Arthroscopy
Condition: Pain, Postoperative
Intervention: Drug: Intravenous Acetaminophen
Outcome Measures: Postoperative pain levels;   Postoperative opioid consumption
17 Recruiting Intravenous Acetaminophen in Craniotomy
Condition: Postoperative Pain
Interventions: Drug: Acetaminophen;   Drug: Placebo
Outcome Measures: Post-Operative Opioid Requirement;   Intra-Operative Opioid Requirement;   Post-Operative Pain;   Post-Operative Side Effects
18 Recruiting Efficacy of IV Acetaminophen for Pain Management
Condition: Post-operative Pain
Interventions: Drug: Placebo (normal saline);   Drug: IV acetaminophen
Outcome Measures: Amount of opioid rescue needed;   Time to return of bowel function (passage of flatus);   Patient Satisfaction;   Cost Effectiveness
19 Recruiting Acetaminophen Versus Ibuprofen in Children With Asthma
Conditions: Asthma;   Wheezing
Interventions: Drug: Acetaminophen;   Drug: Ibuprofen
Outcome Measure: exacerbation frequency
20 Recruiting The Efficacy of Intravenous Acetaminophen During The Perioperative Period Of Neurosurgical Patients Undergoing Craniotomies
Conditions: Craniotomy;   Brain Surgery
Interventions: Drug: Acetaminophen;   Drug: Placebo
Outcome Measures: Opioid requirement after surgery;   Time to rescue medication in both groups;   Amount of rescue medication in PACU in both groups;   Median difference in ICU length of stay/hospital length of stay between both groups;   Number of successful neurologic exams between intervention and placebo group as determined by a neurosurgical provider by answering either Yes or No;   Median difference in temperature between intervention and placebo groups;   Sedation scores measured by RASS every 8 hours for 24 hours in both groups;   Pain VAS scores (1-10) every 8 hours for 24 hours in both groups;   Delirium measured by CAM-ICU every 8 hours for 24 hours in both groups