Department of Emergency Medicine, University of Iowa, Iowa City, IA, United States of America; Iowa Poison Control Center, Sioux City, IA, United States of America.
Department of Emergency Medicine, University of Calgary, Calgary, AB, Canada; Poison and Drug Information Service (PADIS), Section of Clinical Pharmacology and Toxicology, University of Calgary, Calgary, AB, Canada.
Am J Emerg Med. 2021 Sep;47:86-89. doi: 10.1016/j.ajem.2021.03.061. Epub 2021 Mar 24.
Bupropion is an antidepressant medication with expanding indications including smoking cessation, weight loss, attention-deficit/hyperactivity disorder, seasonal affective disorder, and amphetamine dependence. Despite its increasing popularity among providers, it has a well-known narrow therapeutic window which can lead to delayed onset of symptoms with extended-release formulations and devastating consequences in overdose. We have noticed some patients misusing bupropion via intravenous use and had difficulty guiding decisions regarding clinical monitoring in these patients. As this route entirely changes the kinetics of bupropion, this has caused concern within our group. We reviewed all the cases of intravenous bupropion use reported to a single poison center without any other coingestants. The majority (66.7%) of patients had moderate effects and one patient had a seizure. No deaths were reported. All patients were symptomatic by the time of initial call to the poison center if they had any reported symptoms due to bupropion. This case series describes the clinical effects reported, and the timing of these effects, after intravenous bupropion use.
安非他酮是一种抗抑郁药物，其适应证不断扩大，包括戒烟、减肥、注意缺陷多动障碍、季节性情感障碍和安非他命依赖。尽管它在提供者中越来越受欢迎，但它的治疗窗很窄，这可能导致缓释制剂的症状延迟出现，并在过量服用时产生灾难性的后果。我们注意到一些患者通过静脉使用安非他酮来滥用它，并且在这些患者的临床监测决策方面存在困难。由于这种途径完全改变了安非他酮的动力学，这引起了我们小组的关注。我们回顾了向一个单一的中毒中心报告的所有静脉使用安非他酮的病例，没有其他共服药物。大多数（66.7%）患者有中度影响，一名患者出现癫痫发作。没有报告死亡。如果由于安非他酮而有任何报告症状，所有患者在最初向中毒中心打电话时都有症状。本病例系列描述了静脉使用安非他酮后报告的临床效果及其出现时间。
