Good quick review of bupropion toxicity, but . . . whole bowel irrigation? Seriously??

2.5 out of 5 stars Bupropion Abuse and Overdose. Stall N et al. CMAJ 2014 Apr 28 [Epub ahead of print] No abstract available online This one-page précis is part of CMAJ‘s “Five Things To Know About _______” series. The key points include: Bupropion blocks reuptake of dopamine and norepinephrine, and also blocks the action of acetylcholine at nicotinic receptors. Burpropion is abused recreationally for its mild cocaine-like “high.” Routes of bupropion abuse include snorting, ingestion, and intravenous injection. Brupropion lowers the threshold for seizures, which may be delayed as long as 24-hours after ingestion of extended relief formulations. Aside from seizures, manifestations of toxicity include lethargy, tremor, vomiting, and agitation. Cardiovascular manifestations include tachycardia, widened QRS interval, ventricular arrhythmias, and cardiovascular collapse. In cases of bupropion overdose, anticipate seizures and contact the local poison control center. Bupropion-induced seizures are treated initially with benzodiazepines, then barbiturates or propofol if needed (avoid phenytoin.) Intravenous lipid emulsion therapy is unproven but may be helpful. Unfortunately, this otherwise good short summary is marred by the fact that the authors can’t resist adding: “Whole bowel irrigation may be considered for patients with large ingestions of sustained-release preparations.” I don’t know about you, but I would prefer n...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical abuse bupropion overdose seizures Source Type: news