Cydney E. McQueen

Safety issues associated with commercially available energy drinks.

OBJECTIVE To describe benefits and adverse effects associated with the consumption of energy drinks. DATA SOURCES Searches were conducted using Medline, IPA (International Pharmaceutical Abstracts), EMBASE, and MANTIS; databases such as Natural Medicines Comprehensive Database, Natural Standard, ALTMEDEX, and AltHealthWatch; and Google (range 1980 to September 2007). Search terms included energy drink, Red Bull, caffeine, glucose, ginseng, guarana, taurine, and bitter orange. DATA SYNTHESIS Most energy drinks contain natural products such as guarana, ginseng, and taurine. As much as 80 to 300 mg of caffeine and 35 grams of processed sugar per 8-ounce serving are commonly present in energy drinks such as Cocaine, Pimp Juice, Red Bull, and Spike Shooter. No reports were identified of negative effects associated with taurine, ginseng, and guarana used in the amounts found in most energy drinks. Commonly reported adverse effects seen with caffeine in the quantities present in most energy drinks are insomnia, nervousness, headache, and tachycardia. Four documented case reports of caffeine-associated deaths were found, as well as four separate cases of seizures associated with the consumption of energy drinks. CONCLUSION The amounts of guarana, taurine, and ginseng found in popular energy drinks are far below the amounts expected to deliver either therapeutic benefits or adverse events. However, caffeine and sugar are present in amounts known to cause a variety of adverse health effects.

Conception and Implementation of a Drug Information Center Based Fellowship in Natural Product Research

Resurgence of consumer use of natural products has resulted in an increased need for evidence-based information on these products. Recognition of problems associated with meeting that need, the need for the most accurate healthcare education, and the need for identification of required future research resulted in development and implementation of a two-year, post-PharmD fellowship program at a university drug information center. The program equips pharmacists with the skills and knowledge necessary to address these issues. Research associated with the program will provide insight into specific knowledge gaps in scientific evidence and in knowledge levels of healthcare professionals. This insight will guide research and allow development of appropriate educational measures to train healthcare professionals in provision of pharmaceutical care associated with natural products.

Resources for Information on Herbal Medicinals and Dietary Supplements

ALTMEDDEX , ed ited by L. Abt and Milt Hammerly. Englewood, CO. MICROMEDEX, Inc., 2001. , ed ited by L. Abt and Milt Hammerly AltMedDex is the first in a se ries of MICROMEDEX da ta bases of fer ing in for ma tion on var i ous com ple men tary and al ter na tive med i cine (CAM) ther a pies. AltMedDex Eval u a tions are com plete mono graphs on bo tani cals, vi ta mins, min er als, amino ac ids and other di etary sup ple ments. Also in cluded are Royal Phar ma ceu ti cal So ci ety (RPS) mono graphs from Herbal Med i cines by the Royal Phar ma ceu ti cal Press, and Drug Con sults, which are sum ma ries or mini-re views writ ten by one con trib u tor fo cus ing on a par tic u lar is sue. The MICROMEDEX Web site (www.micromedex.com) lists 251 sub stances for which AltMedDex mono graphs are “Cur rently and Soon to be Avail able.” Of the 251 listed sub stances, 132 ac tual AltMedDex Eval u a tions ex ist in the cur rent edi tion (ex pires 2/2001). Mono graphs from MICROMEDEX’s stan dard drug in for ma tion sys tem, AltMedDex ,