Bupropion

Question 1

What is bupropion?

Answer 1

An older antidepressant.

A drug that is used to suppress nicotine craving but was previously used as an antidepressant. Monocyclic anti-depressant that increases CNS levels of excitatory neuroamines by inhibiting NA/dopamine reuptake.

Question 2

What are two possible organ systems that may be affected in bupropion overdose?

Answer 2

CNS: seizures, cardiotoxicity in life threatening overdoses

Question 3

Describe the dose-related risk assessment for bupropion.

Answer 3

Any dose: seizures, tachy, hypertension, tremors, agitation, hallucinations, GI symptoms. > 4.5 grams: seizure risk of 50%. > 9 grams: seizure risk 100%, prolonged QRS/QT, haemodynamic instability. Fatal without intervention.

Question 4

What is the minimum period of observation for all patients following a bupropion overdose?

Answer 4

Minimum of 24 hours of observation until symptom free + any tachycardia resolves

Question 5

What is one measure that can be considered in a known bupropion overdose?

Answer 5

Early prophylactic doses of IV benzos to prevent seizures; dose titrated to a calm patient with a HR of <100