https://doi.org/10.4081/ecj.2021.10037

Acute intoxication following massive bupropion sniffing: A case report

Vol. 17 No. 4 (2021)
Submitted: 13 August 2021
Accepted: 6 December 2021
Published: 20 December 2021
Bupropion, abuse, sniffing, intoxication, case report
Abstract Views: 2070
PDF: 301
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Authors

Simone Sartori
simone.sartori@unifi.it
Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence, Italy.
Valentina Brilli
Medical Toxicology Unit and Poison Control Centre, Careggi University Hospital, Florence, Italy.
Cecilia Lanzi
Medical Toxicology Unit and Poison Control Centre, Careggi University Hospital, Florence, Italy., Italy.
Luca Pratticò
Emergency Department, Azienda USL Toscana sud est, Grosseto, Italy.
Elisabetta Sarcoli
Emergency Department, Azienda USL Toscana sud est, Grosseto, Italy.
Maria Grazia Di Milia
Forensic Toxicology Unit, Medical Toxicology Unit and Poison Control Centre, Careggi University Hospital, Florence, Italy.
Francesco Gambassi
Medical Toxicology Unit and Poison Control Centre, Careggi University Hospital, Florence, Italy.
Guido Mannaioni
Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence; Medical Toxicology Unit and Poison Control Centre, Careggi University Hospital, Florence, Italy.

Bupropion intranasal misuse potential should be considered in the suspect of sympathomimetic syndrome for illicit drug or medication intoxication. A 31-year-old man was admitted for intranasal misuse of 30 crushed tablets of bupropion with adrenergic mild presentation. Lorazepam infusion was started with complete clinical resolution. Further forensic investigations detected a bupropion serum and urine concentration levels at 18 hours from intake of 1905.26 ng/mL and 2001.57 ng/mL, respectively. This case of intranasal bupropion misuse shared only some features with oral overdose, despite a plasma concentration five times higher than the lowest toxic level. Nasal bupropion snorting in chronic users could have lower toxicity compared to other snorted stimulants but symptomatic treatment remains the gold standard for preventing complications. Bupropion misuse might rapidly become a concerning issue and monitoring by healthcare professionals is needed.

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How to Cite

Sartori, S., Brilli, V., Lanzi, C., Pratticò, L., Sarcoli, E., Di Milia, M. G., Gambassi, F., & Mannaioni, G. (2021). Acute intoxication following massive bupropion sniffing: A case report. Emergency Care Journal, 17(4). https://doi.org/10.4081/ecj.2021.10037

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