Circulatory failure after bupropion overdose
A case of massive overdose of sustained release bupropion tablets is described. The patient presented with GCS 3, tachycardic and in vasoplegic shock. ECHO and EKG were initially normal. The hemodynamic situation was stabilised with vasopressors, but 18 h after presentation the patient deteriorated with wide complex arrhythmias rapidly progressing to cardiac arrest. The patient was put on VA-ECMO after 35 minutes of CPR. Circulation could be stabilized and ECMO was discontinued after 36 h. The patient was extubated on day 6 and made a complete recovery on discharge two weeks after presentation. At 34h, with ongoing ECMO, 236 tablets (with visible print identifying them as bupropion) were evacuated from the patient's stomach by gastroscopy. The tablets were analysed by NMR (nuclear magnetic resonance) but no longer contained any active substance. Blood levels of bupropion and hydroxybupropion at 36h were 790 and 1300 µg/l. The case illustrates a worrying surge in serious bupropion poisonings as noted by the Swedish Poisons Information Centre during the last 5 years.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:121 |
|---|---|
| Enthalten in: |
Lakartidningen - 121(2024) vom: 26. März |
| Sprache: |
Schwedisch |
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| Weiterer Titel: |
Allt fler allvarliga förgiftningar med preparatet bupropion |
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| Beteiligte Personen: |
Norberg, Erik [VerfasserIn] |
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| Themen: |
01ZG3TPX31 |
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| Anmerkungen: |
Date Completed 27.03.2024 Date Revised 04.04.2024 published: Electronic Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Norberg, Erik |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Circulatory failure after bupropion overdose |
| 246 | 3 | 3 | |a Allt fler allvarliga förgiftningar med preparatet bupropion |
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| 500 | |a Date Revised 04.04.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a A case of massive overdose of sustained release bupropion tablets is described. The patient presented with GCS 3, tachycardic and in vasoplegic shock. ECHO and EKG were initially normal. The hemodynamic situation was stabilised with vasopressors, but 18 h after presentation the patient deteriorated with wide complex arrhythmias rapidly progressing to cardiac arrest. The patient was put on VA-ECMO after 35 minutes of CPR. Circulation could be stabilized and ECMO was discontinued after 36 h. The patient was extubated on day 6 and made a complete recovery on discharge two weeks after presentation. At 34h, with ongoing ECMO, 236 tablets (with visible print identifying them as bupropion) were evacuated from the patient's stomach by gastroscopy. The tablets were analysed by NMR (nuclear magnetic resonance) but no longer contained any active substance. Blood levels of bupropion and hydroxybupropion at 36h were 790 and 1300 µg/l. The case illustrates a worrying surge in serious bupropion poisonings as noted by the Swedish Poisons Information Centre during the last 5 years | ||
| 650 | 4 | |a Case Reports | |
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| 650 | 4 | |a Journal Article | |
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| 650 | 7 | |a Antidepressive Agents, Second-Generation |2 NLM | |
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| 700 | 1 | |a Blomgren, Andreas |e verfasserin |4 aut | |
| 700 | 1 | |a Stevens, Marc |e verfasserin |4 aut | |
| 700 | 1 | |a Lindeman, Erik |e verfasserin |4 aut | |
| 700 | 1 | |a Nordmark Grass, Johanna |e verfasserin |4 aut | |
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