Home Drug Guide Bupropion Hydrobromide

Drug Guide

Generic Name

Bupropion Hydrobromide

Brand Names Aplenzin

Classification

Therapeutic: Antidepressant, Smoking Cessation Aid

Pharmacological: Norepinephrine-Dopamine Reuptake Inhibitor (NDRI)

FDA Approved Indications

  • Major depressive disorder (MDD)
  • Seasonal affective disorder (SAD)
  • Smoking cessation (as adjunct)

Mechanism of Action

Bupropion inhibits the reuptake of norepinephrine and dopamine, increasing their levels in the synaptic cleft, which helps improve mood and reduce nicotine withdrawal symptoms.

Dosage and Administration

Adult: Initially 174 mg per day, given as 87 mg twice daily, titrating up as tolerated to a maximum of 300 mg per day in divided doses.

Pediatric: Not approved for pediatric use.

Geriatric: Start with lower doses due to increased sensitivity, monitor closely.

Renal Impairment: Use with caution; dose adjustments may be necessary.

Hepatic Impairment: Use caution; lower doses may be required.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Metabolized hepatically, primarily via CYP2B6.

Excretion: Eliminated mainly in urine as metabolites.

Half Life: About 21 hours, facilitating once or twice daily dosing.

Contraindications

  • Seizure disorder
  • History of anorexia or bulimia nervosa
  • Discontinuation syndrome after alcohol or abrupt drug withdrawal
  • Use of monoamine oxidase inhibitors within 14 days

Precautions

  • Risk of seizures, monitor for hypersensitivity, caution in patients with hepatic impairment, history of head trauma, or at risk of hyponatremia.

Adverse Reactions - Common

  • Insomnia (Common)
  • Dry mouth (Common)
  • Sweating (Common)
  • Nausea (Common)

Adverse Reactions - Serious

  • Seizures (Rare)
  • Hypertension (Less common)
  • Psychiatric symptoms (e.g., agitation, hallucinations) (Uncommon)

Drug-Drug Interactions

  • Principal substrate of CYP2B6 (e.g., clopidogrel, cyclophosphamide)
  • Other serotonergic drugs (risk of serotonin syndrome)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor mental status, seizure history, blood pressure, and signs of adverse effects.

Diagnoses:

  • Risk for seizure
  • Imbalanced nutrition: less than body requirements
  • Risk for hypertension

Implementation: Start at low dose, titrate gradually, monitor for adverse effects, counsel on seizure risk.

Evaluation: Evaluate effectiveness in depression or smoking cessation, monitor for adverse effects, seizure activity.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report any signs of agitation, hallucinations, or seizures.
  • Avoid alcohol and sedatives.
  • Attend regular follow-up appointments.

Special Considerations

Black Box Warnings:

  • Risk of suicide in children, adolescents, and young adults.

Genetic Factors: CYP2B6 genetic polymorphisms can affect metabolism and plasma levels.

Lab Test Interference: N/A

Overdose Management

Signs/Symptoms: Seizures, hallucinations, tachycardia, hyperthermia, possibly coma.

Treatment: Supportive care, activated charcoal if ingestion is recent, seizure management, airway support, intensive monitoring.

Storage and Handling

Storage: Store at room temperature, away from moisture, heat, and light.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.