741
Views
0
CrossRef citations to date
0
Altmetric
Clinical Research

Sodium bicarbonate treatment for QRS widening in bupropion overdoses

ORCID Icon, & ORCID Icon
Pages 436-444 | Received 08 Apr 2023, Accepted 19 May 2023, Published online: 15 Jun 2023

References

  • Starr P, Klein-Schwartz W, Spiller H, et al. Incidence and onset of delayed seizures after overdoses of extended-release bupropion. Am J Emerg Med. 2009;27(8):911–915.
  • Rianprakaisang TN, Prather CT, Lin AL, Toxicology Investigators Consortium (ToxIC), et al. Factors associated with seizure development after bupropion overdose: a review of the toxicology investigators consortium. Clin Toxicol (Phila). 2021;59(12):1234–1238.
  • Shrier M, Díaz JE, Tsarouhas N. Cardiotoxicity associated with bupropion overdose. Ann Emerg Med. 2000;35(1):100.
  • Franco V. Wide complex tachycardia after bupropion overdose. Am J Emerg Med. 2015;33(10):1540.e3-1540–e5.
  • Al-Abri SA, Orengo JP, Hayashi S, et al. Delayed bupropion cardiotoxicity associated with elevated serum concentrations of bupropion but not hydroxybupropion. Clin Toxicol (Phila). 2013;51(10):1230–1234.
  • Kolecki PF, Curry SC. Poisoning by sodium channel blocking agents. Crit Care Clin. 1997;13(4):829–848.
  • Bruccoleri RE, Burns MM. A literature review of the use of sodium bicarbonate for the treatment of QRS widening. J Med Toxicol. 2016;12(1):121–129.
  • Wax PM, Haynes A. Sodium bicarbonate. In: Nelson LS, Howland M, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS. editors. Goldfrank’s toxicologic emergencies, 11e. New York: McGraw Hill; 2019. p. 567–573.
  • Caillier B, Pilote S, Castonguay A, et al. QRS widening and QT prolongation under bupropion: a unique cardiac electrophysiological profile. Fundam Clin Pharmacol. 2012;26(5):599–608.
  • Lazar A, Lenkey N, Pesti K, et al. Different pH-sensitivity patterns of 30 sodium channel inhibitors suggest chemically different pools along the access pathway. Front Pharmacol. 2015;6:210.
  • Curry SC, Kashani JS, LoVecchio F, et al. Intraventricular conduction delay after bupropion overdose. J Emerg Med. 2005;29(3):299–305.
  • Wills BK, Zell-Kanter M, Aks SE. Bupropion-associated QRS prolongation unresponsive to sodium bicarbonate therapy. Am J Ther. 2009;16(2):193–196.
  • Biswas AK, Zabrocki LA, Mayes KL, et al. Cardiotoxicity associated with intentional ziprasidone and bupropion overdose. J Toxicol Clin Toxicol. 2003;41(2):101–104.
  • Sathe AR, Thiemann A, Toulouie S, et al. A 19-Year-Old woman with a history of depression and fatal cardiorespiratory failure following an overdose of prescribed bupropion. Am J Case Rep. 2021;22:e931783-1–e931783-5.
  • Livshits Z, Feng Q, Chowdhury F, et al. Life-Threatening bupropion ingestion: is there a role for intravenous fat emulsion? Basic Clin Pharmacol Toxicol. 2011;109(5):418–422.
  • Boehnert MT, Lovejoy FH. Value of the QRS duration versus the serum drug level in predicting seizures and ventricular arrhythmias after an acute overdose of tricyclic antidepressants. N Engl J Med. 1985;313(8):474–479.
  • Mirrakhimov AE, Ayach T, Barbaryan A, et al. The role of sodium bicarbonate in the management of some toxic ingestions. Int J Nephrol. 2017;2017:7831358.
  • Gisev N, Bell JS, Chen TF. Interrater agreement and interrater reliability: key concepts, approaches, and applications. Res Social Adm Pharm. 2013;9(3):330–338.
  • Seger D, Hantsch C, Zavoral T, et al. Variability of recommendations for serum alkalinization in tricyclic antidepressant overdose: a survey of U.S. Poison center medical directors. J Toxicol Clin Toxicol. 2003;41(4):331–338.
  • Shastry S, Ellis J, Loo G, et al. Antidotal sodium bicarbonate therapy: delayed QTc prolongation and cardiovascular events. J Med Toxicol. 2021;17(1):27–36.
  • Chong WH, Saha BK, Medarov BI. Comparing Central venous blood gas to arterial blood gas and determining its utility in critically ill patients: narrative review. Anesth Analg. 2021;133(2):374–378.
  • Teigeler T, Stahura H, Alimohammad R, et al. Electrocardiographic changes in loperamide toxicity: case report and review of literature. J Cardiovasc Electrophysiol. 2019;30(11):2618–2626.
  • Gummin DD, Mowry JB, Beuhler MC, et al. 2021 Annual report of the national poison data system© (NPDS) from america’s poison centers: 39th annual report. Clin Toxicol (Phila). 2022;60(12):1381–1643.
  • Pentel P, Benowitz N. Efficacy and mechanism of action of sodium bicarbonate in the treatment of desipramine toxicity in rats. J Pharmacol Exp Ther. 1984;230(1):12–19.
  • Wilson LD, Shelat C. Electrophysiologic and hemodynamic effects of sodium bicarbonate in a canine model of severe cocaine intoxication. J Toxicol Clin Toxicol. 2003;41(6):777–788.
  • Brubacher J. Bicarbonate therapy for unstable propafenone-induced wide complex tachycardia. CJEM. 2004;6(5):349–356.
  • Herrman NWC, Kalisieski MJ, Fung C. Bupropion overdose complicated by cardiogenic shock requiring vasopressor support and lipid emulsion therapy. J Emerg Med. 2020;58(2):e47–50–e50.
  • Isoardi KZ, Chiew AL. Too much of a good thing: bicarbonate toxicity following treatment of sodium channel blocker overdose. Emerg Med Australas. 2022;34(4):639–641.
  • French D, Smollin C, Ruan W, et al. Partition constant and volume of distribution as predictors of clinical efficacy of lipid rescue for toxicological emergencies. Clin Toxicol (Phila). 2011;49(9):801–809.
  • Gosselin S, Hoegberg LCG, Hoffman RS, et al. Evidence-based recommendations on the use of intravenous lipid emulsion therapy in poisoning. Clin Toxicol (Phila). 2016;54(10):899–923.
  • ACMT position statement: guidance for the use of intravenous lipid emulsion. J Med Toxicol. 2017;13(1):124–125.
  • Robinson S. Treatment of status epilepticus and prolonged QT after massive intentional bupropion overdose with lidocaine. Am J Emerg Med. 2022;55:232.e3-232–e4.
  • Daleau P. Effects of antiarrhythmic agents on junctional resistance of Guinea pig ventricular cell pairs. J Pharmacol Exp Ther. 1998;284(3):1174–1179.
  • Dhein S, Hagen A, Jozwiak J, et al. Improving cardiac gap junction communication as a new antiarrhythmic mechanism: the action of antiarrhythmic peptides. Naunyn Schmiedebergs Arch Pharmacol. 2010;381(3):221–234.
  • Salameh A, Dhein S. Pharmacology of gap junctions. New pharmacological targets for treatment of arrhythmia, seizure and cancer? Biochim Biophys Acta. 2005;1719(1-2):36–58.
  • Liebelt EL, Francis PD, Woolf AD. ECG lead aVR versus QRS interval in predicting seizures and arrhythmias in acute tricyclic antidepressant toxicity. Ann Emerg Med. 1995;26(2):195–201.
  • Manini AF, Nelson LS, Skolnick AH, et al. Electrocardiographic predictors of adverse cardiovascular events in suspected poisoning. J Med Toxicol. 2010;6(2):106–115.
  • Vančura V, Wichterle D, Ulč I, et al. The variability of automated QRS duration measurement. EP Europace. 2017;19(4):636–643.
  • Tomlinson DR, Bashir Y, Betts TR, et al. Accuracy of manual QRS duration assessment: its importance in patient selection for cardiac resynchronization and implantable cardioverter defibrillator therapy. Europace. 2009;11(5):638–642.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.