Caffeine hypokalemia with

Hypokalemia and myopathy are known effects of caffeine toxicity, and severe hjrpokalemia and fatigue and hypokalemia with myopathy have been described before (19). 

Alterations in the serum potassium level are hazardous because they can result in cardiac arrhythmias. Drugs that may cause hyperkalemia despite normal renal function include potassium itself, 13 blockers, digitalis glycosides, potassiumsparing diuretics, and fluoride. Drugs associated with hypokalemia include barium, 13 agonists, caffeine, theophylline, and thiazide and loop diuretics. 

Caffeine toxicity is an uncommon cause of myopathy, but a history of excessive dietary and pharmaceutical consumption of caffeine should be sought in any patient with unexplained myopathy, particularly if there is concomitant hypokalemia (28). 

A. The earliest symptoms of acute caffeine poisoning are usually anorexia, tremor, and restlessness. These are followed by nausea, vomiting, tachycardia, and confusion. With serious intoxication, delirium, seizures, supraventricular and ventricular tachyarrhythmias, hypokalemia, and hyperglycemia may occur. Hypotension is caused by excessive beta-2-mediated vasodilation and is characterized by a low diastolic pressure and a wide pulse pressure. 

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