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Mini Episode: Who Seizes in Bupropion Overdose with Dr Ari Filip MD

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Manage episode 355440524 series 3382933
Content provided by Ryan Feldman and Ryan Feldman PharmD DABAT. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Ryan Feldman and Ryan Feldman PharmD DABAT or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.
  1. TL;DR
    1. Your patient can seize 8-24 hours in, usually they have neurologic symptoms and tachycardia before hand
    2. Tachycardia may be masked by coingestions and symptoms may be very delayed
    3. Do not discharge a patient without discussing observation time with a toxicologist or poison center
    4. Do not dismiss tachycardia and anxiety as situational in a bupropion overdose
  2. Spiller 1994- Review of instant release product overdoses
  3. Shepherd 2004- Seizures in primarily sustained release products
    1. Most seizures had prodromal neuropsychiatric symptoms
  4. Starr 2009- Seizure in XL products.
    1. Tachycardia, tremor, agitation most associated with seizures
    2. Seizure occured as late as 24 hours and 25% occurred after 8 hours
  5. Offerman 2020- Primarily sustained/extended release products
    1. Tachycardia duration, and extent (>120) predicted seizure. (Hypotnesion and neuropsych symptoms also predict)
    2. Late seizure occurred only in those with symptoms on presentation
    3. Those who had cardiac arrest had prehospital seizure= bad sign
  6. Rianprakaisang 2021- ToxIC review of risk factors for seizures
    1. QTc and HR>140 predict seizures

  continue reading

52 episodes

Artwork
iconShare
 
Manage episode 355440524 series 3382933
Content provided by Ryan Feldman and Ryan Feldman PharmD DABAT. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Ryan Feldman and Ryan Feldman PharmD DABAT or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.
  1. TL;DR
    1. Your patient can seize 8-24 hours in, usually they have neurologic symptoms and tachycardia before hand
    2. Tachycardia may be masked by coingestions and symptoms may be very delayed
    3. Do not discharge a patient without discussing observation time with a toxicologist or poison center
    4. Do not dismiss tachycardia and anxiety as situational in a bupropion overdose
  2. Spiller 1994- Review of instant release product overdoses
  3. Shepherd 2004- Seizures in primarily sustained release products
    1. Most seizures had prodromal neuropsychiatric symptoms
  4. Starr 2009- Seizure in XL products.
    1. Tachycardia, tremor, agitation most associated with seizures
    2. Seizure occured as late as 24 hours and 25% occurred after 8 hours
  5. Offerman 2020- Primarily sustained/extended release products
    1. Tachycardia duration, and extent (>120) predicted seizure. (Hypotnesion and neuropsych symptoms also predict)
    2. Late seizure occurred only in those with symptoms on presentation
    3. Those who had cardiac arrest had prehospital seizure= bad sign
  6. Rianprakaisang 2021- ToxIC review of risk factors for seizures
    1. QTc and HR>140 predict seizures

  continue reading

52 episodes

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