Bupropion toxicity

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Background

  • Inhibits reuptake of norepinephrine and dopamine
  • Toxicity occurs with ingestion of >450mg/d

Clinical Features

  1. Agitation
  2. Dizziness
  3. Tremor
  4. N/V
  5. Drowsiness
  6. Tachycardia
  7. Seizure
    1. May develop in isolation from other symptoms
    2. Develops within first 1-4hr for regular-release, up to 8hr for delayed release forms

Treatment

  1. GI decontamination
    1. Consider whole-bowel irrigation for sustained-release formulations
  2. Seizure Treatment
    1. Benzos are 1st line
    2. Barbs are 2nd line

Disposition

  • Consider discharge if asymptomatic after 8hr for regular-release ingestions

Source

  • Tintinalli
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