期刊
AMERICAN JOURNAL OF EMERGENCY MEDICINE
卷 54, 期 -, 页码 269-273出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.ajem.2022.02.025
关键词
Bupropion; Cathinone; Overdose; Bupropion; Cathinone; Overdose
Bupropion overdose requires significant resource utilization and high levels of medical care, which may further increase with expanding indications for its use.
Introduction: Bupropion is an antidepressant with unique mechanisms of action leading to a narrow therapeutic window. Parallel to increasing indications, there is an increasing number of overdoses and fatalities attributable to bupropion overdose. Due to the serious effects of a bupropion overdose including arrhythmias and early or delayed seizures, these patients necessitate prolonged monitoring with high levels of medical care. In the setting of a tertiary care center with a medical toxicology consult service, our institution is heavily relied upon to manage these patients. This study was performed to provide clarity on the resources used, lengths-of-stay, and treatments provided for these patients. Methods: All patients at a tertiary care center with an oral bupropion overdose and a medical toxicology consult less than 24 h after the ingestion were included between July 15, 2017 and October 14, 2021. Chart review was performed to determine lengths-of-stay, the unit of disposition, treatments provided, and outcomes. Results: A total of 73 cases were identified with 36 bupropion-only ingestions. Most cases were transferred from outside facilities, developed seizures, had QRS prolongation; and almost a third required intubation. The vast majority were admitted to an ICU and received GABA-A agonists. A median of 1.47 days per case was spent in the ED or ICU. There was an average of 41.9 ED or ICU bed-days per year and 68.5 non-psychiatric bed-days per year occupied by a patient after a bupropion overdose at a single center. Conclusions: Bupropion overdose necessitates high resource utilization which we believe will increase with the expanding indications for its use. (c) 2022 Elsevier Inc. All rights reserved.
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