High yield highlight- Managing a Bupropion overdose

Ready for a high-octane dose of knowledge? 🔥🧠 Ryan's got you covered with this electrifying mini-episode on managing a bupropion overdose! 💊💥  Beware - there are plenty of pitfalls you'll want to avoid. Check out the full episode and other mini-episodes for even more tips and tricks! 🎧👀Bupropion is the #1 antidepressant cause of major (life threatening) reported to U.S. Poison CentersIt is difficult to manage due toPotential for delayed seizuresUnique cardiogenic shock in overdosePotential wide complex arrhythmia refractory to Sodium Bicarbonate Potential interference with brain death testingTreatmentDecontaminationAggressive whole bowel irrigation or charcoal may be indicated if large ingestionSupportive careIntubation if airway compromisedBenzodiazepine for agitationBenzodiazepines and GABA-ergic AED's for status epilepticsTachycardia, tremor, and agitation are risk factor for seizuresTachycardia may be masked by alpha 2 agonist co ingestionsSeizures may occur 24 hour outSodium bicarbonate for wide QRS (it may be refractory)Inodilators and vasopressors for cardiogenic shockECMO for refractory shock or arrhythmiaAwareness that severe bupropion toxicity can mimic brain deathsend analytical confirmation of bupropion if possible to rule out confoundingEnhanced eliminationlimited options due to protein binding, not routineFocused antidoteConsider IV fat emulsion if the patient is peri arrestObservation timesTalk to a toxicolleague about observation times, decontamination, and use of invasive therapies to avoid falling into a trapSupport the show!Rep the show!Show website