Resumen
En Colombia las intoxicaciones autoinfligidas vienen en aumento en los últimos años, la principal causa son los medicamentos y dentrode éstos, los sicofármacos. El bupropión es un antidepresivo, inhibidor débil de la recaptación de dopamina y noradrenalina; está aprobado para el tratamiento del trastorno depresivo mayor y se ha utilizado en otras indicaciones como: depresión bipolar, abandono del cigarrillo, trastorno por déficit de atención e hiperactividad (TDAH), obesidad y disfunción sexual. Sus principales efectos adversos son cardiovasculares y neurológicos. Esta serie de casos busca evidenciar las complicaciones asociadas a su toxicidad y resaltar algunos aspectos en el manejo de estas intoxicaciones; tales como el uso de la irrigación gastrointestinal y el uso de emulsiones lipídicas. MÉD. UIS. 2020;33(2):117-121.
Referencias
Drug Safety and Availability [Internet]. U.S. Food & Drug Administration. Silver Spring (MD): U.S. Food & Drug Administration; 1985. Disponible en: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/021515s034lbl.pdf
Sheridan DC, Lin A, Horowitz BZ. Suicidal bupropion ingestions in adolescents: increased morbidity compared with other antidepressants. Clin Toxicol (Phila). 018;56(5):360–4.
Sheridan DC, Lin A, Horowitz BZ. Suicidal bupropion ingestions in adolescents: increased morbidity compared with other antidepressants. Clin Toxicol (Phila). 018;56(5):360–4.
Kriikku, P., & Ojanperä, I. The relationship between bupropion and suicide in post-mortem investigations. Forensic scienceinternational. 2016;266:343-8.
Invima. Farmaco vigilancia [Internet]. Disponible en: http:// farmacovigilancia.invima.gov.co:8082/Consultas/consultas/ consreg_encabcum.jsp
European Space Agency. ESA: Missions, Earth Observation: ENVISAT [Internet]. [Consultado 3 Jul 2012]. Disponible en: http://envisat.esa.int/
Overberg A, Morton S, Wagner E, Froberg B. Toxicity of Bupropion Overdose Compared With Selective Serotonin Reuptake Inhibitors. Pediatrics. 019;144(2):e20183295.
Khan SR, Berendt RT, Ellison CD, Ciavarella AB, Asafu-Adjaye E, Khan MA, et al. Bupropion Hydrochloride. Profiles Drug Subst Excip Relat Methodol. 2016;41:1-30.
Sidlak AM, Koivisto KO, Marino RT, Abesamis MG. Serotonin toxicity from isolated bupropion overdoses [published online ahead of print, 2020 Apr 14]. Clin Toxicol (Phila). 2020;1-3.
Lineberry CG, Johnston JA, Raymond RN, Samara B, Feighner JP, Harto NE, et al. A fixed-dose (300 mg) efficacy study of bupropion and placebo in depressed outpatients. J Clin Psychiatry. 1990;51(5):194–9.
Feighner J, Hendrickson G, Miller L, Stern W. Double-blind comparison of doxepin versus bupropion in outpatients with a major depressive disorder. J Clin Psychopharmacol. 1986;6(1):27-32
Overberg A, Morton S, Wagner E, Froberg B. Toxicity of Bupropion Overdose Compared With Selective Serotonin Reuptake Inhibitors. Pediatrics. 2019;144(2): 1-13.
Aplenzin (bupropion hydrobromide) [prescribing information]. Bridgewater, NJ: Bausch Health US, LLC; May 2020. Disponible en: ttps://www.bauschhealth.com/Portals 25/ Pdf/PI/Aplenzin-PI.pdf
Chaudron LH, Schoenecker CJ. Bupropion and Breastfeeding: A Case of a Possible Infant Seizure. J Clin Psychiatry. 2004; 65(6):881-2.
Fava M. Prospective studies of adverse events related to antidepressant discontinuation. J Clin Psychiatry. 2006;67(4):14-21.
Dagan Y, Yager J. Severe bupropion XR abuse in a patient with long-standing bulimia nervosa and complex PTSD. Int J Eat Disord. 2018;51(10):1207-1209.
Givens, M. L., & Gabrysch, J. (2007). Cardiotoxicity associated with accidental bupropion ingestion in a child. Pediatric emergency care, 23(4), 234-237.
Al-Abri, S. A., Orengo, J. P., Hayashi, S., Thoren, K. L., Benowitz, N. L., Olson, K. R. Delayed bupropion cardiotoxicity associated with elevated serum concentrations of bupropion but not hydroxybupropion. Clinical Toxicology. 2013; 51(10), 1230-4.
Morazin, F., Lumbroso, A., Harry, P., Blaise, M., Turcant, A., Montravers, P., et al. Cardiogenic shock and status epilepticus after massive bupropion overdose. Clin Toxicol. 2007. 45(7), 794-7.
Judge BS, Rentmeester LL. Antidepressant overdose-induced seizures. Psychiatr Clin North Am. 2013; 36(2):245-60.
Rivas-Coppola, M. S., Patterson, A. L., Morgan, R., Wheless, J. W. Bupropion overdose presenting as status epilepticus in an infant. Pediatric neurology. 2015;53(3): 257-261.
Starr, P., Klein-Schwartz, W., Spiller, H., Kern, P., Ekleberry, S. E., Kunkel, S. Incidence and onset of delayed seizures after overdoses of extended-release bupropion. Am J Emerg Med. 2009;27(8):911-915.
Noda AH, Schu U, Maier T, Knake S, Rosenow F. Epileptic seizures, coma and EEG burst-suppression from suicidal bupropion intoxication. Epileptic Disord. 2017;19(1):109-113.
Cárdenas-Álvarez JE, Berrouet-Mejía MC. Uso de las emulsiones lipídicas en intoxicaciones por anestésicos locales y otras intoxicaciones: evidencia actual. Rev CES Med 2014; 28(1): 77-90
Cave G, Harvey MG. Should we consider the infusion of lipid emulsion in the resuscitation of poisoned patients?. Crit Care. 2014;18(5):457.
Hoegberg LCG, Gosselin S. Lipid resuscitation in acute poisoning: after a decade of publications, what have we really learned?. Curr Opin Anaesthesiol. 2017;30(4):474-476.
Sirianni, A. J., Osterhoudt, K. C., Calello, D. P., Muller, A. A., Waterhouse, M. R., Goodkin, M. B., et al. Use of lipid emulsion in the resuscitation of a patient with prolonged cardiovascular collapse after overdose of bupropion and lamotrigine. Ann Emerg Med. 2008;51(4):412-5.
Rothschild, L., Bern, S., Oswald, S., Weinberg, G. Intravenous lipid emulsion in clinical toxicology. Scand J Trauma Resusc Emerg Med. 2010;18(1):51.
Levine, M., Hoffman, R. S., Lavergne, V., Stork, C. M., Graudins, A., Chuang, R., et al. Systematic review of the effect of intravenous lipid emulsion therapy for non-local anesthetics toxicity. Clin Toxicol. 2016;54(3):194-221.
Hoegberg LCG, Gosselin S. Lipid resuscitation in acute poisoning: after a decade of publications, what have we really learned?. Curr Opin Anaesthesiol. 2017;30(4):474-476.
Cave, G., Harvey, M., Willers, J., Uncles, D., Meek, T., Picard, J., et al. LIPAEMIC report: results of clinical use of intravenous lipid emulsion in drug toxicity reported to an online lipid registry. J Med Toxicol. 2014;10(2):133-142.
Sheridan DC, Lin A, Horowitz BZ. Suicidal bupropion ingestions in adolescents: increased morbidity compared with other antidepressants. Clin Toxicol (Phila). 018;56(5):360–4.
Sheridan DC, Lin A, Horowitz BZ. Suicidal bupropion ingestions in adolescents: increased morbidity compared with other antidepressants. Clin Toxicol (Phila). 018;56(5):360–4.
Kriikku, P., & Ojanperä, I. The relationship between bupropion and suicide in post-mortem investigations. Forensic scienceinternational. 2016;266:343-8.
Invima. Farmaco vigilancia [Internet]. Disponible en: http:// farmacovigilancia.invima.gov.co:8082/Consultas/consultas/ consreg_encabcum.jsp
European Space Agency. ESA: Missions, Earth Observation: ENVISAT [Internet]. [Consultado 3 Jul 2012]. Disponible en: http://envisat.esa.int/
Overberg A, Morton S, Wagner E, Froberg B. Toxicity of Bupropion Overdose Compared With Selective Serotonin Reuptake Inhibitors. Pediatrics. 019;144(2):e20183295.
Khan SR, Berendt RT, Ellison CD, Ciavarella AB, Asafu-Adjaye E, Khan MA, et al. Bupropion Hydrochloride. Profiles Drug Subst Excip Relat Methodol. 2016;41:1-30.
Sidlak AM, Koivisto KO, Marino RT, Abesamis MG. Serotonin toxicity from isolated bupropion overdoses [published online ahead of print, 2020 Apr 14]. Clin Toxicol (Phila). 2020;1-3.
Lineberry CG, Johnston JA, Raymond RN, Samara B, Feighner JP, Harto NE, et al. A fixed-dose (300 mg) efficacy study of bupropion and placebo in depressed outpatients. J Clin Psychiatry. 1990;51(5):194–9.
Feighner J, Hendrickson G, Miller L, Stern W. Double-blind comparison of doxepin versus bupropion in outpatients with a major depressive disorder. J Clin Psychopharmacol. 1986;6(1):27-32
Overberg A, Morton S, Wagner E, Froberg B. Toxicity of Bupropion Overdose Compared With Selective Serotonin Reuptake Inhibitors. Pediatrics. 2019;144(2): 1-13.
Aplenzin (bupropion hydrobromide) [prescribing information]. Bridgewater, NJ: Bausch Health US, LLC; May 2020. Disponible en: ttps://www.bauschhealth.com/Portals 25/ Pdf/PI/Aplenzin-PI.pdf
Chaudron LH, Schoenecker CJ. Bupropion and Breastfeeding: A Case of a Possible Infant Seizure. J Clin Psychiatry. 2004; 65(6):881-2.
Fava M. Prospective studies of adverse events related to antidepressant discontinuation. J Clin Psychiatry. 2006;67(4):14-21.
Dagan Y, Yager J. Severe bupropion XR abuse in a patient with long-standing bulimia nervosa and complex PTSD. Int J Eat Disord. 2018;51(10):1207-1209.
Givens, M. L., & Gabrysch, J. (2007). Cardiotoxicity associated with accidental bupropion ingestion in a child. Pediatric emergency care, 23(4), 234-237.
Al-Abri, S. A., Orengo, J. P., Hayashi, S., Thoren, K. L., Benowitz, N. L., Olson, K. R. Delayed bupropion cardiotoxicity associated with elevated serum concentrations of bupropion but not hydroxybupropion. Clinical Toxicology. 2013; 51(10), 1230-4.
Morazin, F., Lumbroso, A., Harry, P., Blaise, M., Turcant, A., Montravers, P., et al. Cardiogenic shock and status epilepticus after massive bupropion overdose. Clin Toxicol. 2007. 45(7), 794-7.
Judge BS, Rentmeester LL. Antidepressant overdose-induced seizures. Psychiatr Clin North Am. 2013; 36(2):245-60.
Rivas-Coppola, M. S., Patterson, A. L., Morgan, R., Wheless, J. W. Bupropion overdose presenting as status epilepticus in an infant. Pediatric neurology. 2015;53(3): 257-261.
Starr, P., Klein-Schwartz, W., Spiller, H., Kern, P., Ekleberry, S. E., Kunkel, S. Incidence and onset of delayed seizures after overdoses of extended-release bupropion. Am J Emerg Med. 2009;27(8):911-915.
Noda AH, Schu U, Maier T, Knake S, Rosenow F. Epileptic seizures, coma and EEG burst-suppression from suicidal bupropion intoxication. Epileptic Disord. 2017;19(1):109-113.
Cárdenas-Álvarez JE, Berrouet-Mejía MC. Uso de las emulsiones lipídicas en intoxicaciones por anestésicos locales y otras intoxicaciones: evidencia actual. Rev CES Med 2014; 28(1): 77-90
Cave G, Harvey MG. Should we consider the infusion of lipid emulsion in the resuscitation of poisoned patients?. Crit Care. 2014;18(5):457.
Hoegberg LCG, Gosselin S. Lipid resuscitation in acute poisoning: after a decade of publications, what have we really learned?. Curr Opin Anaesthesiol. 2017;30(4):474-476.
Sirianni, A. J., Osterhoudt, K. C., Calello, D. P., Muller, A. A., Waterhouse, M. R., Goodkin, M. B., et al. Use of lipid emulsion in the resuscitation of a patient with prolonged cardiovascular collapse after overdose of bupropion and lamotrigine. Ann Emerg Med. 2008;51(4):412-5.
Rothschild, L., Bern, S., Oswald, S., Weinberg, G. Intravenous lipid emulsion in clinical toxicology. Scand J Trauma Resusc Emerg Med. 2010;18(1):51.
Levine, M., Hoffman, R. S., Lavergne, V., Stork, C. M., Graudins, A., Chuang, R., et al. Systematic review of the effect of intravenous lipid emulsion therapy for non-local anesthetics toxicity. Clin Toxicol. 2016;54(3):194-221.
Hoegberg LCG, Gosselin S. Lipid resuscitation in acute poisoning: after a decade of publications, what have we really learned?. Curr Opin Anaesthesiol. 2017;30(4):474-476.
Cave, G., Harvey, M., Willers, J., Uncles, D., Meek, T., Picard, J., et al. LIPAEMIC report: results of clinical use of intravenous lipid emulsion in drug toxicity reported to an online lipid registry. J Med Toxicol. 2014;10(2):133-142.
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