IBCC Episode 64 - Bupropion Toxicity

This Internet Book of Critical Care podcast episode discusses bupropion (Wellbutrin) poisoning, highlighting its dangers and treatment strategies. The hosts delve into the pharmacodynamics and pharmacokinetics of bupropion, emphasizing its potential for severe cardiotoxicity and neurotoxicity. They explore evaluation methods, risk stratification, and the importance of early consultation with toxicologists. The discussion covers treatment options such as activated charcoal, whole bowel irrigation, benzodiazepines for seizures, and the controversial use of intralipids. The hosts underscore the need for aggressive supportive care and early consideration of VA-ECMO in severe cases, cautioning that bupropion overdose can mimic brain death and requires vigilance due to the risk of delayed toxicity.