Podcasts about Bupropion

In this episode, Tristan J. Barber, MA, MD, FRCP, and Glenn J. Treisman, MD, PhD, discuss the importance of screening, diagnosing, and treating PTSD in people with HIV. They illustrate their discussion through a patient case and provide strategies for accomplishing this, sharing their own experiences and approaches to thinking about PTSD, structuring appointments, and integrating care. Presenters:Tristan J. Barber, MA, MD, FRCPConsultant in HIV MedicineRoyal Free London NHS Foundation TrustHonorary Associate ProfessorInstitute for Global HealthUniversity College LondonLondon, United KingdomGlenn J. Treisman, MD, PhDEugene Meyer III Professor of Psychiatry and MedicineJohns Hopkins University School of MedicineBaltimore, MarylandDownloadable slides:https://bit.ly/4dBu929Program:https://bit.ly/3WB2VCO

In this video, I read experience reports and talk about the new antidepresant that contains Bupropion and Dextreomethorphan...

In this episode, Bradley N. Gaynes, MD, MPH, and Glenn J. Treisman, MD, PhD, discuss the importance of screening, diagnosing, and treating depression in people living with HIV. They illustrate their discussion through a patient case and provide strategies for accomplishing this, including creation of a virtual network and employment of measurement-based care.Presenters:Bradley N. Gaynes, MD, MPHRay M. Hayworth, MD and Family Distinguished ProfessorProfessor of Psychiatry and EpidemiologyDirector, Division of Global Mental HealthCo-Director, Physician Scientist Training ProgramDepartment of PsychiatryUniversity of North Carolina School of MedicineChapel Hill, North CarolinaGlenn J. Treisman, MD, PhDEugene Meyer III Professor of Psychiatry and MedicineJohns Hopkins University School of MedicineBaltimore, MarylandDownloadable slides: https://bit.ly/3YgqqSOProgram: https://bit.ly/3WB2VCOTo get access to all of our new infectious disease podcast episodes, subscribe to the CCO infectious disease podcast channel on Apple Podcasts, Google Podcasts, or Spotify.  

Welcome to the 35th episode in my drug name pronunciation series.  In this episode, I divide bupropion into syllables, tell you which syllable to emphasize, and share my source.  The written pronunciation is below and in the show notes on thepharmacistsvoice.com.   Bupropion = bue PROE pee on Emphasize PROE. Source: USP Dictionary Online   Thank you for listening to episode 287 of The Pharmacist's Voice ® Podcast.   To read the FULL show notes (including all links), visit https://www.thepharmacistsvoice.com/podcast.  Select episode 287.   If you know someone who needs to learn how to say bupropion, please share this episode with them.  Please subscribe for all future episodes.  This podcast is on all major podcast players and YouTube.  Some popular podcast player links are below.   Apple Podcasts   https://apple.co/42yqXOG  Spotify  https://spoti.fi/3qAk3uY  Amazon/Audible  https://adbl.co/43tM45P YouTube https://bit.ly/43Rnrjt   Links from this episode USP Dictionary Online (Subscription-based resource) USP Dictionary's pronunciation guide (Free resource on The American Medical Association's website)    Kim's websites and social media links: ✅Business website https://www.thepharmacistsvoice.com ✅The Pharmacist's Voice ® Podcast https://www.thepharmacistsvoice.com/podcast ✅Pronounce Drug Names Like a Pro © Online Course https://www.kimnewlove.com  ✅A Behind-the-scenes look at The Pharmacist's Voice ® Podcast © Online Course https://www.kimnewlove.com  ✅LinkedIn https://www.linkedin.com/in/kimnewlove ✅Facebook https://www.facebook.com/kim.newlove.96 ✅Twitter https://twitter.com/KimNewloveVO ✅Instagram https://www.instagram.com/kimnewlovevo/ ✅YouTube https://www.youtube.com/channel/UCA3UyhNBi9CCqIMP8t1wRZQ ✅ACX (Audiobook Narrator Profile) https://www.acx.com/narrator?p=A10FSORRTANJ4Z ✅Start a podcast with the same coach who helped me get started (Dave Jackson from The School of Podcasting)! **Affiliate Link - NEW 9-8-23**   Pronunciation Series Links The Pharmacist's Voice Podcast Episode 285, pronunciation series ep 34 (fentanyl) The Pharmacist's Voice Podcast Ep 281, Pronunciation Series Ep 33 levothyroxine (Synthroid) The Pharmacist's Voice ® Podcast Ep 278, Pronunciation Series Ep 32 ondansetron (Zofran) The Pharmacist's Voice ® Podcast Episode 276, pronunciation series episode 31 (tocilizumab-aazg) The Pharmacist's Voice ® Podcast Episode 274, pronunciation series episode 30 (citalopram and escitalopram) The Pharmacist's Voice ® Podcast Episode 272, pronunciation series episode 29 (losartan) The Pharmacist's Voice Podcast Episode 269, pronunciation series episode 28 (tirzepatide) The Pharmacist's Voice Podcast Episode 267, pronunciation series episode 27 (atorvastatin)  The Pharmacist's Voice Podcast Episode 265, pronunciation series episode 26 (omeprazole) The Pharmacist's Voice Podcast Episode 263, pronunciation series episode 25 (PDE-5 inhibitors) The Pharmacist's Voice Podcast Episode 259, pronunciation series episode 24 (ketorolac) The Pharmacist's Voice ® Podcast episode 254, pronunciation series episode 23 (Paxlovid) The Pharmacist's Voice ® Podcast episode 250, pronunciation series episode 22 (metformin/Glucophage) The Pharmacist's Voice Podcast ® episode 245, pronunciation series episode 21 (naltrexone/Vivitrol) The Pharmacist's Voice ® Podcast episode 240, pronunciation series episode 20 (levalbuterol) The Pharmacist's Voice ® Podcast episode 236, pronunciation series episode 19 (phentermine)  The Pharmacist's Voice ® Podcast episode 228, pronunciation series episode 18 (ezetimibe) The Pharmacist's Voice ® Podcast episode 219, pronunciation series episode 17 (semaglutide) The Pharmacist's Voice ® Podcast episode 215, pronunciation series episode 16 (mifepristone and misoprostol) The Pharmacist's Voice ® Podcast episode 211, pronunciation series episode 15 (Humira®) The Pharmacist's Voice ® Podcast episode 202, pronunciation series episode 14 (SMZ-TMP) The Pharmacist's Voice ® Podcast episode 198, pronunciation series episode 13 (carisoprodol) The Pharmacist's Voice ® Podcast episode 194, pronunciation series episode 12 (tianeptine) The Pharmacist's Voice ® Podcast episode 188, pronunciation series episode 11 (insulin icodec)  The Pharmacist's Voice ® Podcast episode 184, pronunciation series episode 10 (phenytoin and isotretinoin) The Pharmacist's Voice ® Podcast episode 180, pronunciation series episode 9 Apretude® (cabotegravir) The Pharmacist's Voice ® Podcast episode 177, pronunciation series episode 8 (metoprolol)  The Pharmacist's Voice ® Podcast episode 164, pronunciation series episode 7 (levetiracetam) The Pharmacist's Voice ® Podcast episode 159, pronunciation series episode 6 (talimogene laherparepvec or T-VEC)  The Pharmacist's Voice ® Podcast episode 155, pronunciation series episode 5 Trulicity® (dulaglutide)  The Pharmacist's Voice ® Podcast episode 148, pronunciation series episode 4 Besponsa® (inotuzumab ozogamicin) The Pharmacist's Voice ® Podcast episode 142, pronunciation series episode 3 Zolmitriptan and Zokinvy The Pharmacist's Voice ® Podcast episode 138, pronunciation series episode 2 Molnupiravir and Taltz The Pharmacist's Voice ® Podcast episode 134, pronunciation series episode 1 Eszopiclone and Qulipta Thank you for listening to episode 287 of The Pharmacist's Voice ® Podcast.  If you know someone who would like this episode, please share it with them!

Show notes at pharmacyjoe.com/episode938. In this episode, I'll discuss the chance of cardiovascular toxicity from bupropion overdose. The post 938: Can you predict the chance of cardiovascular event from bupropion overdose? appeared first on Pharmacy Joe.

Can the use of hearing aids slow down cognitive decline? Find out about this and more in today's PeerDirect Medical News Podcast.

#21 - Le premier podcast qui te pousse à avoir un sens critique.Podcast du média novateur PERCEPTIÖN, accompagné de Skii et Zak, il est dans le but de mettre en avant des acteurs de la scène underground française.Pour cet épisode, nous avons le plaisir d'avoir discuté avec d'accord Simon (anciennement connu sous le pseudo de 6maz), nous sommes revenu sur son évolution musicale depuis 2023, et sa manière d'aborder ses prochaines étapes, notamment celle de son prochain projet.Dans la suite de cette émission, nous avons d'abord traité de Sim01, et son projet 01, avec un feat Ptite Soeur en tant qu'interprète, et neophron, esone, bahamas, Blizzard, Rosaliedu38 en tant que producteur.Après nous sommes revenus sur la sortie de Wallace Cleaver - plus rien n'est grave, qui est accompagné d'un court-métrage, et annonce sa signature chez Epic Records.Puis pour finir cette rubrique, nous avons parlé du retour de Winnterzuko, avec le clip de North2, qui ne nous a pas laissé unanimes.Donc pour conclure en débat : Quelle est la direction à venir de l'hyperpop en France ?Prochain débat en direct via Discord !------------------------------------------------------------------------------------------------------------------------------------------------Pour retrouver d'accord SimonNos réseaux : PERCEPTIÖN / Zak / SkiiPour participer aux débats : Discord------------------------------------------------------------------------------------------------------------------------------------------------(00:00:00) - Introduction(00:02:33) - La discussion - d'accord Simon(00:15:24) - Les News - Sim01 - 01(00:24:36) - Les News - Wallace Cleaver - plus rien n'est grave(00:32:39) - Les News - Winnterzuko - North2(00:41:22) - La reco' de la semaine - Bupropion par Zak'(00:45:21) - Unpopular Opinion - Quelle est la direction à venir de l'hyperpop en France ?------------------------------------------------------------------------------------------------------------------------------------------------Crédits musicaux :Rubrique 2 :Sim01, ptite soeur, Rosaliedu38, Esone, Neophron - MNG act 3 N°VII in D# MinorSim01, Bahamas - SOMMEILWallace Cleaver - plus rien n'est graveWinnterzuko - NORTH2Reco de la semaine :bupropion. - vole Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

Unlock the science behind weight loss with Bupropion, Naltrexone, and Contrave! But which one is right for you? Discover how these drugs work and a comparison of their effectiveness. For more information about this topic: https://brianyeungnd.com/2024/01/25/bupropion-vs-contrave-vs-naltrexone/ Get EXCLUSIVE content and SUPPORT us: https://ko-fi.com/brianyeungnd

Among most prescribers, bupropion is considered a substance of low misuse potential, with some studies showing lesser misuse potential than caffeine. However, several case reports exist of recreational bupropion misuse and diversion. This podcast, a discussion by authors of their bupropion systematic review, reports that snorting and intravenous injection of bupropion occur almost exclusively in patients with a substance use disorder history, with a preponderance of patients with stimulant use disorder or multiple substance use disorders. Users who divert bupropion from prescribed use describe a brief cocaine-like high of approximately 30 seconds to 5 minutes. The systematic review highlights the bupropion misuse potential in certain patient populations and serves to increase awareness among clinicians of unhealthy results of abuse. Additional patient screening, monitoring and follow-up, surveillance, and further research are needed to investigate and prevent bupropion misuse in at-risk patient populations.   Sahil Munjal, MD, moderates a discussion conducted with his systematic review co-authors Greg Noe, BS, Kaushal Shah, MD, MPH, and Samantha Ongchuan, MD, on bupropion misuse. The article appears in the May/June 2024 issue of the Journal of Clinical Psychopharmacology. The authors are from Wake Forest University School of Medicine, the Department of Psychiatry at Atrium Wake Forest Baptist Health, and the Department of Psychiatry at Wake Forest University in Winston-Salem, NC.

In this episode Dr. Gillian Beauchamp sits down with Dr. Travis Olives to discuss gap junctions and cardiac effects of bupropion toxicity. 

Episode 157: Urine TestingThis episode includes the pitfalls of urine tests, how to detect adulterated urine, and more.  Written by Janelli Mendoza, MSIV, Ross University School of Medicine. Editing by Hector Arreaza, MD. Comments by Carol Avila, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Introduction: Urine drug screenings are valuable tools used every day by physicians to monitor illicit substance use, as well as proper use or misuse of prescription drugs. However, studies suggest that physicians using “clinical judgment” on who and when to test is often wrong and confounded by implicit racial bias. The implications of this are an inappropriate discontinuation of treatment.For example, a study by Gaither, Gordon, and Crystal et. al found that compared to white patients, black patients were 10% more likely to undergo urine drug screening. In addition, they were 2-3 times more likely to have long-term opioid medication abruptly discontinued as a result of a UTOX positive for marijuana.False positive urine tests:Before getting into the current guidelines, let's discuss the interpretation of Urine Drug Screenings. It's important to be aware of prescription drugs that may cause false positives:· Bupropion, labetalol, pseudoephedrine, trazodone → Amphetamines· HIV antivirals, sertraline → Benzodiazepines· HIV antivirals, NSAIDs, PPI's → Cannabinoids· Diphenhydramine, Naloxone, Quetiapine, Quinolones, Verapamil → Opioids· Dextromethorphan, diphenhydramine, ibuprofen, tramadol, venlafaxine → PhencyclidineTampering of urine: Other factors to consider are the tampering of collected urine. The tampering of collected urine may include diluting the urine, or adding other chemicals and substances. Laboratory results that should prompt consideration of adulteration are: Creatinine

High Yield Psychiatric Medications Antidepressants Review for your PANCE, PANRE, Eor's and other Physician Assistant exams. Review includes SSRI's, SNRIs, TCAs, MAOIs, Atypical antidepressants, Serotonin modulators. TrueLearn PANCE/PANRE SmartBank:https://truelearn.referralrock.com/l/CRAMTHEPANCE/Discount code for 20% off: CRAMTHEPANCEIncluded in review: Citalopram, Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Desvenlafaxine, Duloxetine, Levomilnacipran , Milnacipran, Venlafaxine, Amitriptyline, Clomipramine, Doxepin, Imipramine, Trimipramine, Desipramine, Nortriptyline, Protriptyline, Tranylcypromine, Isocarboxazid, Phenelzine Selegiline, Bupropion, Mirtazapine, Trazodone

There are many reasons why patients misuse medications. Today, Joseph Pierre shakes us out of our 1990s understanding of addiction and explains a new trend, misuse of uncontrolled medications like Bupropion, Quetiapine and the Gabapentinoids.CME: Take the CME Post-Test for this EpisodePublished On: 10/23/2023Duration: 24 minutes, 34 secondChris Aiken, MD, and Kellie Newsome, PMHNP have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

The post Episode 107. Bupropion Toxicity with Thom Maciulewicz appeared first on The Pharm So Hard Podcast.

We're taking a short summer break, but we'll be back in September with brand-new episodes. Can't wait? Join our Kashlak family at patreon.com/curbsiders for access to twice-monthly bonus episodes… there are already 9 of them available to feed your brain hole! Yummy! Obesity treatment has been around since the 1950s but we've been underutilizing it for far too long! Not only that, we've been thinking about obesity the wrong way for decades. Join us with Dr. Fatima Cody Stanford (@AskDrFatima) of Massachusetts General Hospital as we reframe our approach to this disease and learn tips on prescribing  older,  but still very effective, medications used to treat obesity.  Free CME for this episode at curbsiders.vcuhealth.org Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Producer, Writer, Show Notes, Infographics, Cover Art: Isabel Valdez, PA-C Show Notes, Infographics: Maddison McLellan Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Monee Amin, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Fatima Cody Stanford, MD  Sponsor: Locumstory Get a comprehensive view of Locumstory at locumstory.com Sponsor: Babbel .Get 55% off your Babbel subscription at Babbel.com/curb. Rules and restrictions apply.  CME Partner: VCU Health CEThe Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org. Show Segments Intro, disclaimer, guest bio Guest one-liner by Dr. Fatima Cody Stanford Case from Kashlak  Guidelines for treatment  Getting the history and discussing weight goals The Care Team:  Dietician, Behavioral Specialist, Provider Medications: Phentermine, Topiramate, Bupropion, Naltrexone Obesity treatment in pregnancy Referring to bariatric surgery Take home points Outro

00:00-19:00 Introduction to brain death guidelines19:00-28:00 Introduction to limitations in guidelines regarding overdose28:30-38:00 Interview with ACMT Position statement author39:00- End- Interview with Bupropion brain death mimic authors and summaryLinks references in showAmerican Academy of Neurology Bran death guidanceACMT Position statement on brain death in overdoseBrain death mimics with cerebral edemaCase report of “hypoxic patient with diffuses cerebral edema” who recovered in 48 hourCarbamazepine with diffuse cerebral edema who recoveredCases taking >2 months to recover brain stem reflexeshttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(02)07577-3/fulltexthttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4543058/Attempts to withdraw care in as little as 48 hours Dr. Stranges case reportDr. Reyes case reportNarrative review of brain death mimicsIntroductory casesCaroline Burns- Patient who woke up on operating tablePaul Maturo- Patient woke up in a morgue

I wanted to warn anyone taking this medication of the side effects. --- Send in a voice message: https://podcasters.spotify.com/pod/show/nicole-cannon/message

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Bupropion Trade Name Wellbutrin Indication Depression, smoking cessation, treat ADHD in adults Action Not well understood, ↑ dopaminergic and noradrenergic transmission via reuptake Therapeutic Class Antidepressants, smoking deterrents Pharmacologic Class Aminoketones Nursing Considerations • May lead to seizures, suicidal thoughts • Do not administer if patient is taking MAOI • Use caution with renal and liver impairment • Assess mental status • Instruct patient to avoid alcohol (may lead to hallucinations, seizures, anxiety)

Did maternal mortality rates rise in the US in 2021? Find out about this and more in today's PVRoundup podcast.

This is the 8th podcast episode for the Psychiatric Medication Podcast Series. Series Description: Current literature indicates that podcasts can be an effective educational format to reach health professionals across the continuum of medical education, addressing a myriad of topics pertinent to providers. This episode serves as an overview of Bupropion/Wellbutrin. This podcast season is the second released by East Carolina University's Office of Continuing Medical Education and may be beneficial for physicians, residents, fellows, nurse practitioners, physician assistants, and nurses. This podcast season is comprised of approximately 30 episodes, each focusing on different psychiatric medications for the non-psychiatric provider. Those tuning into the podcast's second season will receive a primer on the "bread and butter" behavioral health medications for primary care: antidepressants, antipsychotics, and mood stabilizers. Episodes will be released weekly on Wednesdays.Michael Lang, MD, FACP, DFAPA & Monica Sharma, MD

In treating a 26-year-old man with panic disorder who is otherwise healthy, you consider prescribing:A. Bupropion.B. Alprazolam.C. CitalopramD. Risperidone---YouTube: https://www.youtube.com/watch?v=dDYv02H0iDI&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=8Visit fhea.com to learn more!

 Bupropion is the #1 antidepressant cause of major (life threatening) reported to U.S. Poison Centers It is difficult to manage due to Potential for delays seizuresUnique cardiogenic shock in overdosePotential wide complex arrhythmia refractory to Sodium Bicarbonate Potential interference with brain death testingTreatmentDecontaminationAggressive whole bowel irrigation or charcoal may be indicated if large ingestion Supportive careIntubation if airway compromisedBenzodiazepine for agitationBenzodiazepines and GABA-ergic AED's for status epilepticsTachycardia, tremor, and agitation are risk factor for seizuresTachycardia may be masked by alpha 2 agonist co ingestionsSeizures may occur 24 hour outSodium bicarbonate for wide QRS (it may be refractory)Inodilators and vasopressors for cardiogenic shockECMO for refractory shock or arrhythmiaAwareness that severe bupropion toxicity can mimic brain deathsend analytical confirmation of bupropion if possible to rule out confoundingEnhanced eliminationlimited options due to protein binding, not routineFocused antidoteConsider IV fat emulsion if the patient is peri arrestObservation timesTalk to a toxicolleague about observation times, decontamination, and use of invasive therapies to avoid falling into a trap 

 This antidepressant is the #1 cause of major (life threatening) effects in overdose reported to U.S. Poison CentersIt is difficult to manage due toPotential for delays seizuresUnique cardiogenic shock in overdosePotential wide complex arrhythmia refractory to Sodium Bicarbonate Potential interference with brain death testingToxicityIt increases dopamine and norepinephrine, it also blocks the gap junction in the cardiac myocyteRohr 2004- Gap junction blockade can cause a wide QRVink 2004 Connexin 43 is the most important protein for connexon formation and cardiac signal transmissionCallier 2012- Bupropion does not block sodium channels, and does exhibit similar effects on the cardiac action potential as known gap junctionBurnham 2014 Bupropion has an IC50 for connexin 43 >50 uMol, larger than other drugs such as fluoextine and lamotrigineShaikh Quereshi 2014 Bupropion interferes with connexin43 production and localization in chicken cardiac myoctes at concentration >50 uMolEffectsSympathetic toxidromeSeizuresTL;DRYour patient can seize 8-24 hours in, usually they have neurologic symptoms and tachycardia before handTachycardia may be masked by coingestions and symptoms may be very delayedDo not discharge a patient without discussing observation time with a toxicologist or poison centerDo not dismiss tachycardia and anxiety as situational in a bupropion overdoseShepherd 2004- Seizures in primarily sustained release productsMost seizures had prodromal neuropsychiatric symptomsStarr 2009- Seizure in XL products. Tachycardia, tremor, agitation most associated with seizuresSeizure occured as late as 24 hours and 25% occurred after 8 hoursOfferman 2020- Primarily sustained/extended release productsTachycardia duration, and extent (>120) predicted seizure. (Hypotnesion and neuropsych symptoms also predict)Late seizure occurred only in those with symptoms on presentationThose who had cardiac arrest had prehospital seizure= bad signRianprakaisang 2021- ToxIC review of risk factors for seizuresQTc and HR>140 predict seizuresUnique cardiogenic shock in overdosePotential wide complex arrhythmia refractory to Sodium Bicarbonate Potential interference with brain death testingTreatment DecontaminationAggressive whole bowel irrigation or charcoal may be indicated if large ingestionSupportive careIntubation if airway compromisedBenzodiazepine for agitationBenzodiazepines and GABA-ergic AED's for status epilepticsTachycardia, tremor, and agitation are risk factor for seizuresTachycardia may be masked by alpha 2 agonist co ingestionsSeizures may occur 24 hour outSodium bicarbonate for wide QRS (it may be refractory)Inodilators and vasopressors for cardiogenic shockECMO for refractory shock or arrhythmiaAwareness that severe bupropion toxicity can mimic brain deathsend analytical confirmation of bupropion if possible to rule out confoundingEnhanced eliminationlimited options due to protein binding, not routineFocused antidoteConsider IV fat emulsion if the patient is peri arrestObservation timesTalk to a toxicolleague about observation times, decontamination, and use of invasive therapies to avoid falling into a trapNot all ingestions are made the same   

TL;DRYour patient can seize 8-24 hours in, usually they have neurologic symptoms and tachycardia before handTachycardia may be masked by coingestions and symptoms may be very delayedDo not discharge a patient without discussing observation time with a toxicologist or poison centerDo not dismiss tachycardia and anxiety as situational in a bupropion overdoseSpiller 1994- Review of instant release product overdoses Shepherd 2004- Seizures in primarily sustained release productsMost seizures had prodromal neuropsychiatric symptomsStarr 2009- Seizure in XL products. Tachycardia, tremor, agitation most associated with seizuresSeizure occured as late as 24 hours and 25% occurred after 8 hours Offerman 2020- Primarily sustained/extended release productsTachycardia duration, and extent (>120) predicted seizure. (Hypotnesion and neuropsych symptoms also predict)Late seizure occurred only in those with symptoms on presentationThose who had cardiac arrest had prehospital seizure= bad signRianprakaisang 2021- ToxIC review of risk factors for seizuresQTc and HR>140 predict seizures 

Rohr 2004- Gap junction blockade can cause a wide QRS Vink 2004 Connexin 43 is the most important protein for connexon formation and cardiac signal transmissionCallier 2012- Bupropion does not block sodium channels, and does exhibit similar effects on the cardiac action potential as known gap junction  Burnham 2014 Bupropion has an IC50 for connexin 43 >50 uMol, larger than other drugs such as fluoextine and lamotrigineShaikh Quereshi 2014 Bupropion interferes with connexin43 production and localization in chicken cardiac myoctes at concentration >50 uMol

Dr. Becky Lynn is back! Previous on Episode #44 and #43 where we talked about vaginismus and endometriosis and sex after breast cancer (44) and hormones (43). So check them out! She is the founder of Evora Women's Health in Missouri Dr. Lynn recently authored the paper: Low Sexual Desire in Breast Cancer Survivors and Patients: A Review - Sexual dysfunction is 30-100% of women with breast cancer. And low desire is 5-87% - What happens when we do surgery on the breasts o Does it matter if we had radical mastectomy versus lumpectomy, with or without reconstruction? - Role of Chemotherapy on sexual function - Role of anti-estrogen meds on sexual function - Role of couples therapy - Data on vaginal moisturizers on sexual function - Role and safety of vaginal estrogen after breast cancer treatment – ACOG statement paper - Trial of Bupropion – open study shows improvement – randomized controlled trial versus placebo pending - Role of vaginal testosterone cream in pts on Aromatase Inhibitors – lowers estrogen in the body - There is a study looking at intravaginal DHEA on sexual function in breast cancer - Abstract at ISSWSH on Addyi (filbanserin) in breast cancer population - Role of hormones after breast cancer Dr. Lynn is a proponent of medical marijuana for better sex 34% OF WOMEN WHO REPORTED USING MARIJUANA BEFORE SEXUAL ACTIVITY SAID IT INCREASED THEIR SEX DRIVE, IMPROVED ORGASM, AND DECREASED PAIN. Luo F, Link M, Grabenhorst C, Lynn B. Low Sexual Desire in Breast Cancer Survivors and Patients: A Review. Sex Med Rev. 2022 Jul;10(3):367-375. website: https://evorawomen.com/ FB/IG @evorawomenshealth TikTok: @dr.beckylynn FB/IG Becky Kaufman Lynn, MD YouTube: search Dr. Becky Lynn YouTube: search Evora Women's Health Twitter: @Becky Lynn Did you get the You Are Not Broken Book Yet? https://amzn.to/3p18DfK Join my membership to get these episodes ASAP when they are created and without advertisement and even listen live to the interviews and episodes. www.kellycaspersonmd.com/membership Our podcast sponsor is Bonafide Bonafide products help women embrace the natural changes that occur throughout all phases of life. Discount code for 20% off:NOTBROKEN Sales link: https://hellobonafide.com/notbroken

Episode 107: Weight Gain Meds. Medications that cause weight gain are also called weight positive medications. Sapna, Danish, and Dr. Arreaza mention some of those medications in this episode. Introduction: Some meds cause weight gainBy Hector Arreaza, MD.You will see patients who keep gaining weight regardless of their sincere efforts to eat better and exercise. Some people experience serious difficulties to lose weight. If you want to know how frustrating it can be, imagine your doctor telling you to add one more inch to your height when you are 35 years old. For some people, losing weight is just as hard. One important step you can take to help your patients lose weight is performing a detailed medication reconciliation. Review the medication list, and you may find some meds that are proven to cause weight gain. Today we will discuss some of those medications, but it takes practice to learn all of them. I hope this episode is helpful for you. This is the Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.___________________________Weight Gain Meds. By Sapna Patel, MS4, and Danish Khalid, MS4. Ross University School of Medicine. Comments by Hector Arreaza, MD. S: Medications associated with weight gain: See Table 1.1 for medications associated with weight gain and alternatives. Antipsychotic agents:A: Ziprasidone is an antipsychotic medicine that causes the least amount of weight gain.Antidepressants:There are many antidepressants which are associated with weight gain, including the tricyclics, monoamine oxidase inhibitors (MAOIs), and some of the selective serotonin reuptake inhibitors (SSRIs). Tricyclic antidepressants, in particular amitriptyline, clomipramine, doxepin, and imipramine, are associated with significant weight gain.Selective serotonin reuptake inhibitors, paroxetine exhibited the greatest weight gain in its class. Whereas fluoxetine exhibited little to no weight gain and remains weight neutral in the class. Amongst the monoamine oxidase inhibitors, phenelzine had the greatest weight gain.  Antiepileptics/Antiseizure: Amongst the antiepileptic drugs used to treat seizures, neuropathic pain, or other psychiatric conditions,  valproate, carbamazepine, and gabapentin are associated with weight gain. Gabapentin is virtually used by all our diabetic patients. Antihypertensive agents: Beta BlockersBeta receptors, specifically beta-2 receptors, stimulate the release of insulin. Thus, patients on beta blockers may experience weight gain as a side effect. There are two beta blockers that cause the least amount of weight gain: Carvedilol (Coreg) and nebivolol (Bystolic). Hypoglycemic medications: Although intended to regulate blood sugar levels, several anti-diabetic medications are associated with weight gain, specifically sulfonylureas, Actos, and insulin. As mentioned earlier, metformin as well as GLP-1 agonists are associated with weight loss. Metformin can be considered weight neutral. Steroids: Steroid hormones such as corticosteroids or progestational steroids are associated with weight gain. Steroids may increase levels of cortisol, one of the end pathways in steroidogenesis. Cortisol, also known as the stress hormone, functions by increasing insulin resistance, and decreasing glucose utilization, thus causing weight gain.  Antihistamine Medications: Diphenhydramine (Benadryl): commonly used for allergies…or how my mom used it, puts you to sleep right before a flight. However, a side effect of using this medication includes weight gain.Cyproheptadine: an antihistamine, used for antidote to serotonin syndrome and migraines, has an appetite stimulant effect causing weight gain. It can be used off-label as an appetite stimulant in children who do not gain weight. Fun Fact: Although it is a common belief that combined oral contraceptives cause weight gain, data suggest that significant weight gain is not a common side effect of combined oral contraceptives. A good practice: Medication reconciliation: Weight positive, weight neutral, or weight negative. Weight positive: Deprescribe or change for another medication if possible. Weight neutral and weight negative: Keep them. Don't be afraid to prescribe anti-obesity meds. We should learn about them, become familiar with side effects, contraindications, dosing, and more, and prescribe them appropriately as part of a weight loss program. Also, don't forget that these medications are used in conjunction with a proper diet.        CategoryDrug ClassWeight GainAlternatives Psychiatric agentsAntipsychoticsClozapine, risperidone, olanzapine, quetiapine, haloperidol, perphenazineZiprasidone, aripiprazoleAntidepressants/mood stabilizers: tricyclic antidepressantsAmitriptyline, doxepin, imipramine, nortriptyline, trimipramine, mirtazapine Bupropion, nefazodone, fluoxetine (short term), sertraline (

Not medical licensed advice . Always consult with your doctor:New Treatments For ObesityBMI: 25-30 : overweight  >30 ObeseWHO 2016 40% are over weight and 13% obese slightly higher in females . This is triple that in 1975UK 2019 House of Commons Library  40% are overweight and 30% obese higher in middle aged and elderly menNHS 2021: Children Obesity has gone up in 12 years from 19% to 25% The Surprising Link Between Chronic Inflammation & Obesity—Plus What You Can Do About ItMay 5th 2021Leptins are hormones produced by adipocytes that communicate with the hypothalamus to reduce eating. If you have too much leptin you become leptin resistant and do not stop eating. High leptin levels are also associated with  chronic inflammation.Conversely losing weight reduces systemic inflammation. REVIEW articleFront. Physiol., 29 January 2020Sec. Clinical and Translational PhysiologyChronic Adipose Tissue Inflammation Linking Obesity to Insulin Resistance and Type 2 DiabetesFrederika ZatteralThe key mediator of inflammation in obesity is the innate immune system cell the macrophage that can account for up to 40% of adipose tissue and it differentiates into a pro-inflammatory M1 macrophage setting up chronic inflammation.Obesity and Inflammation: A Vicious CycleDoes obesity cause inflammation or does inflammation lead to obesity?Jun 25, 2020Jennifer LutzObesity causes chronic inflammation via a chronic immune reaction initiated in the adipose tissue but inflammatory cells can go round the body. In addition gut inflammation may be a result also of the poor diet that led to the obesity.We know that obesity has tripled in the last 50 years such that 40% of the western world are obese. In fact 75% are prediabetic.Cardiovascular disease leading to cardiac disease and strokes, diabetes, cancer, depression, osteoarthritis all feed back and make it more likely you will continue to be obese.Higher adiposity and mental health: causal inference using Mendelian randomization Francesco Casanova,Jessica O'Loughlin,Susan Martin,Robin N Beaumont,Andrew R Wood,Edward R Watkins,Rachel M Freathy,Saskia P Hagenaars,Timothy M Frayling,Hanieh Yaghootkar... Show moreAuthor NotesHuman Molecular Genetics, Volume 30, Issue 24, 15 December 2021, Pages 2371–2382, There is a bidirectional relationship between depression and obesity.Genetic sorting showed that it is obesity per se and not the metabolic unhealthiness due to the obesity such as diabetes that leads to depression.That said diabetes from obesity causes depression although obesity itself causes systemic inflammation which is an independent risk factor for depression and cancer.There are also huge psychosocial effects of obesity on mood.Once-Weekly Semaglutide in Adults with Overweight or ObesityNew England Journal Of Medicine March 2021John P.H. Wilding,Once a week subcutaneous Semaglutide reduced weight by up to 20%Semaglutide is a GLP-1 agonist so suppresses Glucagon and increases insulin hence controlling blood sugar. It also slows gastric emptying  increasing satiety and acts on Receptors in the Arcuate Nucleus in the brain to increase satiety.It is already licensed to treat Type 2 diabetes.It also reduces the risk of cardiovascular complication in Type 2 diabetes and at a cellular level reverses atherogenesis. There is a question on worsening the risk of retinopathy.Other GLP-1 agonists : Liraglutide Setmelanotide.CpdFDA Approved Medication for treating ObesityPhentermine, diethylpropion,benzphetamine, phendimetrazine , Orlistat, Phentermine/topiramate Qsymia, Bupropion/naltrexone, Semaglitide, Liraglutide, setmelanotideCpd Phentermine-topiramate: First combination drug for obesityInt J Applied Med Res 2015Singh et alPhentermine is a centrally acting sympathomimetic that reduces appetite and topiramate enhances GABA ergic transmission reducing Dopamine Response to food.This combination causes up to 10% weight loss maintained in 50% for 2 years.The relationship between early weight loss and weight loss maintenance with naltrexone bupropion therapy.THe Lancet Discovery Science 2022Le Roux et alNaltrexone blocks opiate receptors and bupropion (wellbutrin/zyban) blocks reuptake of dopamine  -reward pathways- .and noradrenaline . Weight loss is maintained at 1 yearBoth medications enhance each other on feeding and satiety

In episode 515, James and Mike invite Allison Paige to the podcast for the first time. Alli takes us through all the evidence around a combination product (naltrexone/bupropion) for weight loss. We talk about all the numbers we have for benefit, harm and cost and we put this agent into the context of the other […]

Bupropion-dextromethorphan combo in depression. Lithium for COVID-19. The top med for nicotine cessation. Mirtazapine in OCD. Mediterranean diet in depression. CME: Podcast CME Post-Tests are available using this subscription. If you have already enrolled in that program, please log in.Published On: 07/04/2022Duration: 20 minutes, 21 secondsReferenced Article: Chris Aiken, MD, Kellie Newsome, PMHNP have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Bupropion Trade: Wellbutrin Use: Antidepressant PotassiumTrade: K-DurUse: Hypokalemia CarvedilolTrade: CoregUse: HTN

Download the cheat: https://bit.ly/50-meds  View the lesson: https://bit.ly/BupropionWellbutrinNursingConsiderations    Name Bupropion Trade Name Wellbutrin Indication Depression, smoking cessation, treat ADHD in adults Action Not well understood, ↑ dopaminergic and noradrenergic transmission via reuptake Therapeutic Class Antidepressants, smoking deterrents Pharmacologic Class Aminoketones Nursing Considerations • May lead to seizures, suicidal thoughts • Do not administer if patient is taking MAOI • Use caution with renal and liver impairment • Assess mental status • Instruct patient to avoid alcohol (may lead to hallucinations, seizures, anxiety)

Methamphetamine use disorder...we see it every day in the Emergency Department, and yet it feels like we have nothing to offer as far as treatment. Could there be some hope that we finally have some medications for methamphetamine use disorder? In this episode we review a recent study on the use of Bupropion and Naltrexone for the treatment of methamphetamine use disorder.

There are some scary ingestions out there and I think we'd all agree that bupropion (Wellbutrin) is on the short list of drugs that should make us worry. Learn how to recognize and manage toxicity, especially the neurogenic and cardiac effects of bupropion in the first episode of the third season of Toxicology podcasts from […]

Learn how to prescribe affordable, effective medications for obesity medicine! We discuss metformin, naltrexone, bupropion, phentermine, topiramate, GLP1 agonists, and how to counsel patients about the available weight loss modalities. Dr. Fatima Cody Stanford (@AskDrFatima) of Massachusetts General Hospital helps reframe our approach as she walks through these Obesity Medicine FAQs. Obesity treatment has been around since the 1950s but we've been underutilizing it for far too long! Claim free CME for this episode at curbsiders.vcuhealth.org! Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Credits Producer, Writer, Show Notes, Infographics, Cover Art: Isabel Valdez, PA-C Show Notes, Infographics: Maddison McLellan Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Reviewer: Monee Amin, MD Executive Producer: Beth Garbitelli Showrunner: Matthew Watto MD, FACP Editor: Clair Morgan of nodderly.com Guest: Fatima Cody Stanford, MD  Sponsor: ACP Join us in Chicago for internal medicine's premier educational meeting April 28-30, 2022! We'll be there in person. For the Early Bird discount: use code IM22CURB. Visit annualmeeting.acponline.org to learn more.  Sponsor: Grammarly Our listeners can get 20% off Grammarly Premium at grammarly.com/CURB Sponsor: MedMastery Listers are eligible for a lifetime 15% off discount on subscription if you go to https://www.medmastery.com/curbsiders! CME Partner: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.  Show Segments Intro, disclaimer, guest bio Guest one-liner by Dr. Fatima Cody Stanford Case from Kashlak  Guidelines for treatment  Getting the history and discussing weight goals The Care Team:  Dietician, Behavioral Specialist, Provider Medications: Phentermine, Topiramate, Bupropion, Naltrexone Obesity treatment in pregnancy Referring to bariatric surgery Take home points Outro

Eine körperliche Auseinandersetzung unter befreundeten Kollegen im Rocker-/Drogenmilieu endet tödlich, obwohl dies dem ersten Anschein nach gar nicht gewollt war. Wer war(en) der(die) Mörder und welche juristische Argumentationslinie könnte sich in dieser speziellen Fallkonstellation als strafmildernd auswirken?

En este video revisamos la farmacología de los medicamentos más usados y más efectivos para dejar de fumar, el bupropion y la vareniclina.Checa el video aquí: https://youtu.be/lgy3Zfpj4akVisita nuestra tienda en línea para comprar nuestros libros y material educativo:https://bit.ly/3i6eAnGSi necesitas una consulta aquí nos puedes encontrar:http://bit.ly/3aUSt12Ayúdanos a encontrar los mejores hospitales para estudiar:https://bit.ly/36o82LXUnete al equipo de Mecenas en YouTube desde 1 dolar al mes: http://bit.ly/2O1AtsXSupport the show (https://www.paypal.com/donate?hosted_button_id=2ENWQ7V289PBE)

Join us as we discuss "Bupropion and Naltrexone in Methamphetamine Use Disorder"  by Madhukar H. Trivedi, M.D. et al from the January 2021 NEJM.   Hosted by Dr. Paula Cook and Dr. Darlene Petersen.    No explicit language, but this podcast discusses the abuse and treatment of legal and illegal drugs and may not be appropriate for all listeners.     

Episode 47: Hearing Carotid Lung.  Dr Civelli explains the updates on screening for lung cancer, hearing loss and carotid artery stenosis; Kafiya explains the use of bupropion and naltrexone in methamphetamine abuse, question of the month pneumonia.Introduction: Methamphetamine useBy Kafiya Arte, MS4, and Ariana Lundquist, MD.Today is April 12, 2021.Bakersfield, California, has a methamphetamine (meth) epidemic currently ravaging this area. We as health care workers believe we can spot somebody addicted to meth from a mile away by their characteristic “older-than-stated-age” appearance and obvious “meth mouth”. However, the actual scope of the epidemic is much larger. It’s not just people who are experiencing homelessness that are addicted to, and dying from, meth.  I saw while volunteering at a needle exchange at Weill Park, people getting out of nice-looking cars wearing clean, pressed clothes with sharps containers full of used needles ready to exchange. One man even had a teacup poodle in tow. It’s clear that meth can affect anybody.  Between May 10 and June 10, 2014, 31.8% of randomly selected patients in the ED of Kern Medical admitted to having used methamphetamine at least once in their life. It’s not just the individual who addicted to meth who is affected. 36.1% of children removed from their home by child protective services in Kern County during the month of May 2014 were cases that involved methamphetamine[1]. Meth accounted for nearly 75% of all drugs seized by the Bakersfield Police Department[2]. Statewide, meth kills more Californians than any single opioid alone[3]. Amphetamine overdose deaths have increased 212% from 777 in 2012 to 2,427 in 2018 in California. In 2020, Kern County had more than double the rate of deaths related to overdose of psychostimulants, of which meth was the dominant drug, compared to the state of California (20.48/100k residents versus 8.21/100k residents, respectively)[3]. This devastating problem, unfortunately, does not have a currently FDA-approved drug to treat it. A promising study called Accelerated Development of Additive Treatment for Methamphetamine Disorder (ADAPT-2), assessed the efficacy of combined bupropion and naltrexone for the treatment of meth use disorder. Bupropion decreases the dysphoria of meth withdrawal that drives continued use; while naltrexone decreases cravings, therefore preventing relapse, as it does with alcohol use disorder.  A total of 403 participants with nearly daily meth use were included in the two-stage randomized, double blind trial conducted at 8 different sites from May 23, 2017 to July 25, 2019. The efficacy of extended-release injectable naltrexone (380 mg every 3 weeks) combined with once-daily oral extended-release bupropion (450 mg) was evaluated, as compared to placebo.  The results of the study showed a 13.6% response rate in the naltrexone-bupropion group and only 2.5% response with placebo. A response was defined as at least three meth negative urine samples out of four samples obtained at the end of each of the two stages.  The trial concluded that although the response rate among participants that received naltrexone and bupropion was low, it was higher than that among participants who received placebo. Although the ADAPT-2 trial did not provide any recommendations that can be adapted to clinical practice, it serves as a starting point for further research of the additive or synergistic effects of bupropion and naltrexone in the treatment of meth use disorder.  Hopefully, it will also serve as a catalyst for more pioneering research regarding the legitimization of meth use disorder as a treatable disease with major medical, psychiatric, socioeconomic and legal consequences. Clinicians should stay up to date with research regarding meth use disorder such as ADAPT-2, as it is our duty to understand the health crises that affect our patients on a daily basis, and the tools we can use to treat them.This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it’s sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. ________________________________Question of the MonthWritten by Hector Arreaza, MD, read by Jennifer Thoene, MDThis is a 69-yo male patient, who has history of controlled hypertension. He comes to an urgent care clinic for acute onset of fever (102 F), cough, and shortness of breath which has progressively worsened over the last 3 days. He does NOT smoke, but uses recreational marijuana once a month, and drinks 1-2 beers a week. He goes to the doctor once a year for check-ups. He takes benazepril 10 mg daily for his hypertension. He does not believe in vaccines and his last shot was a tetanus shot 5 years ago. No surgical history. He retired as an accountant 5 years ago. Vital signs are normal except for tachycardia of 110 (his baseline is 85) and temperature of 101.5 F (38.6 C). He has bibasilar crackles on auscultation. You perform labs in clinic and he has a white count of 13.5, and a chest x-ray shows a right lower lobe consolidation. He has a negative rapid COVID-19 test. What are your top 3 differential diagnoses and what is the acute management of this patient’s condition?Let’s repeat the question: What are your top 3 differential diagnoses and what is the acute management of a 69-year-old male, non-smoker, who has fever, cough, shortness of breath, tachycardia, bibasilar crackles, elevated WBCs, a right lower lobe consolidation, and a negative rapid COVID-19 test?Send us your answer before May 7, 2021, to rbresidency@clinicasierravista.org and the best answer will win a prize!     Hearing Carotid LungBy Valerie Civelli, MD, and Ariana Lundquist, MDScreening for hearing loss in older adultsHearing loss definition: To answer this, let’s first talk Hertz and Decibels. Many studies and guidelines define mild hearing loss as the inability to hear frequencies associated with speech processing under 25 dB and moderate hearing loss as the inability to hear those frequencies under 40 dB[5].  The most important range for speech processing is typically 500 to 4000 Hz. To check hearing, we often use pure-tone audiometry, which is the most standard quantitative measurement; however, this is not a perfect test. There is often discordance between objectively measured deficits and subjective perceptions of hearing problems. In one study, 1 in 5 persons who reported hearing loss had a normal hearing test result, while 6% of those with severe hearing loss detected on audiometry did not report feeling that they had hearing loss.[6]  I wonder if their significant other would agree with the 6% who self-reported no hearing loss but failed the hearing test?  That would be a great study! Risk factors for hearing loss: The #1 risk factor for hearing loss is increasing age. Hearing loss increases with age after 50 attributable to normal degeneration of hair cells in the ear.  This leads to the most common cause of hearing loss in older adults: Presbycusis.  Presbycusis is your diagnosis for patients with gradual, worsening of perceived high-frequency tones. Insufficient evidence for screening: If the patient reports hearing loss, you should order a hearing test. However, on March 23, 2021, for asymptomatic adults 50 years or older, the US Preventive Services Task Force (USPSTF) published a statement that re-confirmed the 2012 recommendations. That is, current evidence is insufficient to assess the balance of benefits and harms of screening for hearing loss in older adults without symptoms. This statement aligns with the AAFP and is referenced in their practice guidelines. This recommendation applies to asymptomatic older adults (age >50 years) who have not noticed any issues with their hearing. It excludes adults with conductive hearing loss, congenital hearing loss, sudden hearing loss, or hearing loss caused by recent noise exposure, or those reporting signs and symptoms of hearing loss.Screening for Carotid Artery StenosisDo not screen: For the general adult population without symptoms of carotid artery stenosis, do not screen. This is a Grade D recommendation for all adults without a history of stroke or neurologic signs or symptoms of a transient ischemic attack. This is a re-endorsement statement made in Feb of this year, 2021, recommitting to 2014 statements.  The evidence continues to show that the harms of screening for asymptomatic carotid artery stenosis outweigh the benefits. The USPSTF has made other recommendations related to stroke prevention and cardiovascular health. These include: Screening for high blood pressure in adultsScreening for abdominal aortic aneurysmInterventions for tobacco smoking cessation in adults, including pregnant personsInterventions to promote a healthy diet and physical activity for the prevention of cardiovascular disease:In adults with cardiovascular risk factorsIn adults without known cardiovascular risk factorsAspirin use to prevent cardiovascular disease and colorectal cancerStatin use for the primary prevention of cardiovascular disease in adultsLung Cancer Screening Grade B recommendation: On March 9, 2021, there are updated Grade B recommendations by the USPSTF.  For patients 50-80 years old, with a 20 pack-year history of smoking and still smoke or quit within 15 years, annual screening with low dose CT is now recommended.Stop screening when a person has not smoked for 15 year, or has a condition that substantially limits life expectancy or limits their ability to undergo curative lung surgeryThe USPSTF modified guidelines so we are screening earlier and with lower pack years.  It used to be recommended to do low dose Chest CT at age 55-80, but it’s now at 50-80.  Also, pack-years was 30 but it’s now at 20 pack-years that we should screen for lung cancer.  So, screen sooner at 50, and at lower threshold of 20. Screen for lung cancer in male and female patients.Conclusion: Now we conclude our episode number 47 “Hearing Carotid Lung”. Dr Civelli gave us an update on USPSTF screening in asymptomatic adults. For hearing loss, there is insufficient evidence to give a recommendation. For carotid artery stenosis, there is a grade D, meaning do not screen. And for lung cancer screening, it is a grade B recommendations, meaning screen your patients. Don’t forget to order a low dose CT of chest in patients of ANY sex, OLDER than 50 years, WITH a 20 pack/year smoking history, and currently smoking or quit less than 15 years ago. That’s a mouthful, but once you start following the guideline, it gets easier to recall.Remember, even without trying, every night you go to bed being a little wiser. Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Jennifer Thoene, Valerie Civelli, Kafiya Arte, Arianna Lundquist, Jacqueline Uy, and voluntarily unidentified medical assistants. Audio edition: Suraj Amrutia. See you next week! _____________________References:The Impact of Methamphetamine in Kern County: 2014, Update September 2014, Kern County Mental Health Department, https://transforminglocalcommunities.com/wp-content/uploads/2018/05/tlc-the-impact-of-meth-in-kern-county-2014-update.pdf Klein, Kerry, To Bakersfield Cops, Concern For Opioids Grows - But Meth Is Still King. Valley Public Radio News, NPR for Central California. May 1, 2019, https://www.kvpr.org/post/bakersfield-cops-concern-opioids-grows-meth-still-king#stream/0 California Opioid Overdose Surveillance Dashboard, California Department of Public Heallh, https://skylab.cdph.ca.gov/ODdash/, accessed on March 27, 2021. Klein, Kerry, Meth Is Making A Comeback In California – And It’s Hitting The San Joaquin Valley Hard. Valley Public Radio News, NPR for Central California. June 28, 2019, https://www.kvpr.org/post/meth-making-comeback-california-and-it-s-hitting-san-joaquin-valley-hard#stream/0 Feltner C, Wallace IF, Kistler CE, et al. Screening for Hearing Loss in Older Adults: An Evidence Review for the U.S. Preventive Services Task Force [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2021 Mar. (Evidence Synthesis, No. 200.) Chapter 1, Introduction. Available from: https://www.ncbi.nlm.nih.gov/books/NBK569275/   US Preventive Services Task Force. Screening for Hearing Loss in Older Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2021;325(12):1196–1201. doi:10.1001/jama.2021.2566. https://jamanetwork.com/journals/jama/fullarticle/2777723.    Screening for Hearing Loss in Older Adults, March 23, 2021, US Preventive Services Task Force, https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hearing-loss-in-older-adults-screening#fullrecommendationstart Screening for Asymptomatic Carotid Artery Stenosis, February 02, 2021, US Preventive Services Task Force, https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/carotid-artery-stenosis-screening. Lung Cancer: Screening, March 09, 2021, US Preventive Services Task Force, https://uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening.    

安非他命成癮有可能用藥物治療嗎？治療的效果好不好？ 概念相對抽象的「成癮」臨床試驗，要怎麼定義客觀的治療指標？要如何設計研究，排除精神醫學治療常見的安慰劑效應？ 這期導讀的論文是近年來少數發表在《新英格蘭醫學期刊》 (NEJM)的成癮臨床試驗。從研究設計與臨床意義都值得大家認識。我們也在最後與大家分享：如何快速讀完這篇論文喔！ 論文原文: Bupropion and Naltrexone in Methamphetamine Use Disorder. NEJM 2021;384:140-153 https://www.nejm.org/doi/full/10.1056/NEJMoa2020214 Powered by Firstory Hosting

#JeanMaIntensa​ #JeanMary​ En esta entrega hablaremos de las enfermedades mentales. Nos reconoceremos en nuestros grises, porque hay cosas (muchas, de hecho) que escapan a nuestro control y eso, está bien. Esta noche nos tomamos un té con una Jean Mary desnuda. Bueno, no en el sentido literal de la palabra, ese otro desnudo lo dejaremos para un futuro proyecto en Onlyfans.https://twitter.com/jeanmary_​https://twitter.com/ConnectorNow​Síguenos en IG:https://www.instagram.com/jeanmary_/​https://www.instagram.com/connectornow/​Entra en nuestro Servidor de Discord:https://discord.com/invite/connectornow​Producción General:Alex Goncalves https://twitter.com/elalexgoncalves​https://www.instagram.com/elalexgonca...​Agencia Digital:Weplash Agencyhttps://weplashagency.com/​Diseño Grafico ConnectorNOW:https://www.instagram.com/elgoldblum/​Edición:Alex Goncalveshttps://www.instagram.com/elalexgonca...​Sergio Schmilinskyhttps://www.instagram.com/seargee_/​Tema “Jean Mary es una Intensa”Letra: Alvaro Mora y FamasloopMúsica: FamasloopMotion Graphics - Cesar Kensenhttps://www.instagram.com/cesarkensen/​Una producción deConnector Media House, LLCSHOW LESS AllRecently uploadedWatched

Drs Kurt DeVine & Heather Bell continue the series on drugs felt to be safe, but aren't necessarily safe!  In episode 3 of the series, we discuss Bupropion (aka Wellbutrin), an antidepressant often diverted and abused. To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct and Facebook: @theaddictionconnectionhk

Drs Kurt DeVine & Heather Bell continue the series on drugs felt to be safe, but aren't necessarily safe!  In episode 3 of the series, we discuss Bupropion (aka Wellbutrin), an antidepressant often diverted and abused. To learn more about the doctors as well as keep up with current happenings follow us on twitter: @echocsct and Facebook: @theaddictionconnectionhk

Bupropion and restless legs syndrome: a randomized controlled trialWhen a patient complains that their mood got worse on an antidepressant, it doesn’t necessarily mean they are sensitive to medications. In this episode, we detail 6 other reasons why depression can get worse on an antidepressant. Published On: 2/15/21 Duration: 22 minutes, 42 seconds Article Referenced: "Are SSRIs Associated With Increased Rates of Violence?" The Carlat Psychiatry Report, February 2021 Got feedback? Take the podcast survey.

Get all the details on varenicline, nicotine replacement therapy, and integrating psychosocial interventions into a comprehensive smoking cessation treatment plan! Smoking cigarettes is the leading cause of preventable death worldwide. Listen as our esteemed guest Dr. Steve Baldassarri (Yale) (https://medicine.yale.edu/profile/stephen_baldassarri/) provides us expert pearls to help our patients quit smoking.  Episodes (https://thecurbsiders.com/episode-list) | Subscribe (https://anchor.fm/s/4108bcf4/podcast/rss) | Spotify (https://open.spotify.com/show/3SKlzOLxyztvA1BkJfnf67) | Swag! (https://www.teepublic.com/user/kashlakmemorial) | Top Picks (https://thecurbsiders.com/top-picks) | Mailing List (https://thecurbsiders.com/knowledgefood) | thecurbsiders@gmail.com (mailto:thecurbsiders@gmail.com) | Free CME! (http://curbsiders.vcuhealth.org) Credits Written and produced by: Carolyn Chan, MD Infographic: Edison Jyang Cover Art: Kate Grant Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Cyrus Askin, MD (written materials); Clair Morgan of nodderly.com (https://www.nodderly.com/) Guest: Steve Baldassarri MD MHS Sponsor: The American College of Physicians Join us for ACP Internal Medicine Meeting 2021: Virtual Experience for 3 days of interactive, livestreaming education and events April 29 through May 1—plus on-demand post-meeting access to CME credit for up to 3 years.   “Early Bird” members get an additional $80 registration discount on top of their member discount. Visit annualmeeting.acponline.org (https://annualmeeting.acponline.org/?utm_source=curbsiders&utm_medium=banner&utm_campaign=MD0020-6) . (Prices shown online at registration pages reflect Discounted Rates.)   Register now (https://annualmeeting.acponline.org/?utm_source=curbsiders&utm_medium=banner&utm_campaign=MD0020-6) —Early Bird savings end January 31st! Sponsor: VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education (https://cme.vcuhealth.org/) to offer FREE continuing education credits for physicians and other healthcare professionals. Visit http://curbsiders.vcuhealth.org. Time Stamps* *Note: Time Stamps refer to ad free version.  03:02 Intro, disclaimer, guest bio 04:35 Guest one-liner  09:50 Tobacco Use Disorder - Chronic Disease 11:08 Case from Kashlak 11:56 Obtaining a history 13:39 Motivations for Smoking Cessation 15:29 Factors associated with challenges in smoking cessation: 21:40 Gradual Tapers vs Cold Turkey 25:18 Nicotine Replacement 32:40 28:57 Pharmacotherapy - “Controller” Medications 31:05 Pharmacotherapy - Short Acting Medications 33:20 Dosing Medications 38:35 Varenicline 39:00 Nicotine gum dosing  44:40 Duration of therapy 48:08 Bupropion  49:05 Behavioral Interventions 55:24 Vaping and electronic cigarettes  57:03 Vaping for smoking cessation 01:02:35 EVALI 01:05:49 Outro

Atomoxetine is the only non-stimulant medication approved by the FDA for the treatment of ADHD in adults. We discuss: Its most common and not-so-common side effects. What other non-stimulants you can use. Faculty: Oscar Bukstein, M.D. Hosts: Jessica Diaz, M.D.; Flavio Guzman, M.D. Learn more about Premium Membership here Earn 1 CME- "The Clinical Guide to Adult ADHD" Nonstimulant Treatments for Adult ADHD: Atomoxetine, Bupropion, Alpha Agonists, and Others

Seasonal Affective Disorder (SAD) was first acknowledged in the mid-1980s and affects between 2% and 10% of Americans every year. Nearly three-fourths of those affected by SAD are women SAD is thought to be caused by problematic circadian rhythms and imbalances in hormones and neurotransmitters, including serotonin and melatonin, and can result in annually persistent and potentially debilitating symptoms Symptoms of SAD Hypersomnia Fatigue Increase appetite and weight gain Difficulty waking in the morning Feeling depressed or sad much of the day Loss of interest Sluggishness Feelings of hopeless/worthlessness Circadian Rhythms The body has a master circadian clock that resides in the suprachiasmatic nucleus (SCM)within the hypothalamus and coordinates rhythms throughout the brain and other systems of the body. The SCM is stays in tune with what's happening outside the body by tracking light cues through the retina. So circadian rhythms are generated by feedback loops that cycle every 24 hours maintaining the balance of hormones and systems in the body. The brain uses 20% of the energy for the entire body, so it needs to do so in an efficient manner. And circadian rhythms in the brain are incredibly important for maximizing energy efficiency and health of the neurons. When we're awake, neurons are constantly firing in response to stimuli. And all of that activity creates the buildup of something called reactive oxygen species (ROS) and other by-products. And during sleep, antioxidants remove excess ROS and other byproducts. Disruptions to the timing and duration of sleep and wake will disrupt these processes. In fact, a recent study found that even one night of sleep deprivation can result in an accumulation amyloid-beta (one of the proteins that accumulates in the brain in Alzheimer's disease). So, efficient brain function depends on consistent sleep-wake timing. Patients suffering from SAD often present with a phase-delayed circadian system, meaning that they fall asleep too late in the evening and awaken too early. This alters the body's natural rhythm of hormone secretion affecting mood and energy levels. If patients with winter depression have phase delayed circadian rhythms then adjusting the sleep phase should help regulate the circadian rhythm and improve mood and brain function. Treatment Light Therapy: One to two hours of 10,000 LUX light every morning may cause a corrective phase advance. However, it is important to speak with a specialist who can help you understand the best timing and intensity of light therapy. Side effects include mild visual complaints, nausea, dizziness, headaches, tired eyes, agitation, sleep disturbance, and sometimes hypomania. Melatonin: Research has shown mixed results for the effectiveness of melatonin in helping to correct imbalances in circadian rythm Bupropion (i.e., Wellbutrin XR): Research has suggested that Bupropion may help relieve the symptoms of SAD in some patients Supplements such as St. John's Wort, Kava, Ginko Biloba, and Tryptophan have not been extensively studied for treatment of SAD, though some individuals have reported positive results for the treatment of SAD. Ketchesin, K. D., Becker‐Krail, D., & Mcclung, C. A. (2018). Mood‐related central and peripheral clocks. European Journal of Neuroscience, 51(1), 326-345. doi:10.1111/ejn.14253 Øverland, S., Woicik, W., Sikora, L., Whittaker, K., Heli, H., Skjelkvåle, F. S., . . . Colman, I. (2019). Seasonality and symptoms of depression: A systematic review of the literature. Epidemiology and Psychiatric Sciences, 29. doi:10.1017/s2045796019000209 Zghoul, T. (2020). Can we prevent seasonal affective disorder (SAD) with melatonergic agents? BJPsych Advances, 26(4), 193-197. doi:10.1192/bja.2020.25

Summary - Long-term pharmacotherapy is available and effective for several addictions - Medication + counseling = recovery - Smoking cessation - Nicotine replacement is available over-the-counter - Bupropion and varenicline are available by prescription for smoking cessation - Multiple medications are available by prescription for alcohol dependence - Methadone/buprenorphine maintenance proven to reduce mortality, crime, & spread of infection - Substitution therapy to eliminate withdrawal, cravings, & heroin effects - Individualized dose Learn more about your ad choices. Visit megaphone.fm/adchoices

Summary - Long-term pharmacotherapy is available and effective for several addictions - Medication + counseling = recovery - Smoking cessation - Nicotine replacement is available over-the-counter - Bupropion and varenicline are available by prescription for smoking cessation - Multiple medications are available by prescription for alcohol dependence - Methadone/buprenorphine maintenance proven to reduce mortality, crime, & spread of infection - Substitution therapy to eliminate withdrawal, cravings, & heroin effects - Individualized dose

Initiating Pharmacologic Treatment in Tobacco-Dependent Adults. An Official American Thoracic Society Clinical Practice Guideline https://www.atsjournals.org/doi/full/10.1164/rccm.202005-1982ST ultimate take home- varenicline is first line!! For Tobacco-Dependent Adults in Whom Treatment Is Being InitiatedShould Treatment Be Started with Varenicline or a Nicotine Patch? 40 more per 1,000 patients; Compared with a nicotine patch, varenicline increased long-term abstinence, measured at 6-month follow-up (RR, 1.20; 95% CI, 1.09 to 1.32; ARR, 40 more per 1,000 patients;) For Tobacco-Dependent Adults in Whom Treatment Is Being Initiated Should Treatment Be Started With Varenicline or Bupropion? 77 more per 1,000 patients taking Varenicline increased tobacco abstinence at 6-month follow-up compared with bupropion (RR, 1.30; 95% CI, 1.19 to 1.42; ARR, 77 more per 1,000 patients;) who andrew so just varenicline by itself?? thats it?? should Treatment Be Started with Varenicline plus Nicotine-Replacement Therapy or Varenicline Alone? 105 more per 1,000 patients; taking Varenicline plus a nicotine patch significantly increased abstinence compared with varenicline alone, (RR, 1.36; 95% CI, 1.07 to 1.72; ARR, 105 more per 1,000 patients; 95% CI, 21 more to 211 more; high certainty in the estimated effects) they mention ecigs vs varenicline and admit we dont have direct evidence but indirect evidence says varenicline is better but they admit because we dont have good evidence and all we have is indirect evidence then base on that go with varenicline but it is given a conditional rec with very low certainty of evidence. In Tobacco-Dependent Adults Who Are Not Ready to Discontinue Tobacco Use, Should Clinicians Begin Treatment with the Optimal Controller or Wait Until They Are Ready to Stop Tobacco Use? to me this was huge maybe one of the biggest recommendation because I always wait till the person is ready to stop but in studies where people could stop or were not interested in stopping those started on varenicline were more like to stop smoking. my mind was blown!! and the evidence on this gives a strong recommendation, with moderate certainty in the estimated effects. infact 173 more per 1,000 smokers were able to stop smoking at 6 months after starting varenicline despite the provider not waiting for affirmation of readiness (RR, 2.00; 95% CI, 1.70 to 2.35; ARR, 173 more per 1,000 patients; 95% CI, 121 more to 234 more; high certainty in the estimated effects). Tobacco-Dependent Adults with Comorbid Psychiatric Conditions, Including Substance-Use Disorder, Depression, Anxiety, Schizophrenia, and/or Bipolar Disorder, for Whom Treatment Is Being Initiated, Should Clinicians Start with the Optimal Controller Identified for Patients without Psychiatric Conditions or Use a Nicotine Patch? “boxed warning regarding possible neuropsychiatric adverse events for both varenicline and bupropion. These concerns stemmed from case reports and postmarketing surveillance, as no RCTs found evidence for these events and early observations suggested no significant increase in neuropsychiatric adverse events with pharmacotherapy compared with placebo, even among patients with preexisting mental illness.” to summarize --with moderate certainty compared with nicotine patches, varenicline 1) may result in a large benefit for nicotine abstinence and 2) compared with nicotine patches, varenicline would likely result in little to no difference in SAEs and last but not least- if you are given the choice to write a script for an Extended-Duration (>12 wk) or Standard-Duration (6–12 wk) then with a strong recommendation and moderate certainty in the estimated effects you should always chose the longer- go with 12 weeks! Guntupalli SR et al. Safety and efficacy of apixaban vs enoxaparin for preventing postoperative venous thromboembolism in women undergoing surgery for gynecologic malignant neoplasm: A randomized clinical trial. JAMA Netw Open 2020 Jun 1; 3:e207410. Following surgery for gynecologic malignancies, The American Society of Clinical Oncology has developed guidelines for postoperative VTE prophylaxis and they recommend almost 1 month of subcutaneous low-molecular-weight heparin is recommended to prevent venous thromboembolism (VTE); however, patients' hate this!! giving shots! randomized trial of 28 days of subcutaneous enoxaparin (40 mg daily) versus oral apixaban (2.5 mg twice daily) in 400 women (median age, 58) undergoing open or minimally invasive surgery for gynecologic cancer. primary end point of this study was the incidence of major bleeding events occurring during the treatment phase and in the 30 days after treatment. Major bleeding was defined as fatal bleeding and/or symptomatic bleeding in a critical area or organ or bleeding requiring the transfusion of 2 units of packed red blood cells. Major bleeding was limited to one participant in each group, incidence of clinically relevant nonmajor bleeding (hematoma, bruising, epistaxis, and vaginal bleeding) was similar between groups (12 [apixaban] and 19 [enoxaparin]), and VTE occurred in 2 and 3 patients, respectively. In the apixaban group, satisfaction was greater regarding ease of use (99% vs. 59%; P

In this episode, we cover the 2019 version of a TCA overdose: Bupropion. AKA: Wellbutrin / Illbutrin (Shoutout to Tox & The Hound). Read the post then get an audio summary of the clinical diagnosis, risk stratification, Activated charcoal, whole-bowel irrigation and finally all things VA-ECMO for the extreme toxicities.

Bupropion

Author: Erik Verzemnieks, MD Educational Pearls: Buproprion is used as an antidepressant and for smoking cessation Severe buproprion overdoses can cause seizures and lead to cardiac dysrhythmias Benzodiazepines are treatment of choice for seizures Bicarbonate and Interlipid are also possible treatment options with less evidence References Stall N, Godwin J, Juurlink D. Bupropion abuse and overdose. CMAJ. 2014 Sep 16;186(13):1015. doi: 10.1503/cmaj.131534. Epub 2014 Apr 28. PubMed PMID: 24778361; PubMed Central PMCID: PMC4162783. Balit CR, Lynch CN, Isbister GK. Bupropion poisoning: a case series. Med J Aust. 2003 Jan 20;178(2):61-3. PubMed PMID: 12526723. Bruccoleri RE, Burns MM. A Literature Review of the Use of Sodium Bicarbonate for the Treatment of QRS Widening. J Med Toxicol. 2016 Mar;12(1):121-9. doi: 10.1007/s13181-015-0483-y. Review. PubMed PMID: 26159649; PubMed Central PMCID: PMC4781799.

James Sherer, MD and Rafael Coira, MD, JD discuss the diagnosis and treatment of video game addiction. James recaps his panel at PACS East and we share our experiences with games growing up.Sources:1.       Zajac K, Ginley M, Chang R, Petry N. Treatments for Internet Gaming Disorder and Internet Addiction: A Systematic Review. Psychology of Addictive Behaviors. 2017, Vol. 31, No. 8, 979–9942.       King D, Delfabbro P. Internet Gaming Disorder Treatment: A Review of Definitions of Diagnosis and Treatment Outcome. Journal of Clinical Psychology. 2014, 40: 942-9553.       Gonzalez-Bueso V, Santamaria J, Fernandez D, Merino L, Montero E, Ribas J. Association between Internet Gaming Disorder or Pathological VideoGame Use and Comorbid Psychopathology: A Comprehensive Review. Int J Environ Res Public Health. 2018, Apr; 15(4):6684.       Greenfield D. Treatment Considerations in Internet and Video Game Addiction. Child and Adolescent Psychiatric Clinics of North America. 2018, Vol. 27, No. 2, 327-3445.       Han D.H., Hwang J.W., and Renshaw P.F.: Bupropion sustained release treatment decreases craving for video games and cue-induced brain activity in patients with Internet video game addiction. Exp Clin Psychopharmacol 2010; 18: pp. 297-3046.       Han D.H., and Renshaw P.F.: Bupropion in the treatment of problematic online game play in patients with major depressive disorder. J Psychopharmacol 2012; 26: pp. 689-6967.Bullock SA, Potenza MN. Pathological gambling: neuropsychopharmacology and treatment. Curr Psychopharmacol. 2012;1:67–85. 8.Kim SW, Grant JE, Adson DE, Shin YC. Double-blind naltrexone and placebo comparison study in the treatment of pathological gambling. Biol Psychiatry. 2001;49:914–21. 9.Grant JE, Odlaug BL, Potenza MN, Hollander E, Kim SW. Nalmefene in the treatment of pathological gambling: multicentre, double-blind, placebo-controlled study. Br J Psychiatry. 2010;197:330–1.  

Author: Aaron Lessen, MD Educational Pearl: A double ingestion of a single pill is typically a benign event but several drug classes may cause problems A published review of 10 years of single medication double dose ingestion found 12 out of 876 cases had adverse events. The drugs and events were: Propafenone ingestion leading to ventricular tachycardia Beta blocker ingestion leading to bradycardia and hypotension Calcium channel blocker leading to bradycardia and hypotension Bupropion ingestion leading to seizures Tramadol ingestion leading to ventricular tachycardia Editor’s Note: References: Correia MS, Whitehead E, Cantrell FL, Lasoff DR, Minns AB. A 10-year review of single medication double-dose ingestions in the nation's largest poison control system. Clin Toxicol (Phila). 2019 Jan;57(1):31-35. doi: 10.1080/15563650.2018.1493205. Epub 2018 Nov 28. PubMed PMID: 30484705. Summarized by Travis Barlock, MS4 | Edited by Erik Verzemnieks, MD

In this episode I discuss bupropion pharmacology.  I cover the mechanism of action, side effects, and some relevant drug interactions. Important information in this episode includes: Possible indications for bupropion like depression and smoking cessation Risk of lowering seizure threshold Inhibition of CYP2D6 Dosage form considerations Pearls for onset of bupropion's action

Want to look cool like a toxicology consultant, sipping coffee on rounds? Ever check a patient for armpit sweat? Learn the secrets of tox from the titans of toxicology podcasting, The Dantastic Mr. Tox & Howard (AKA Dr. Dan Rusyniak and Dr. Howard Greller), as they loquaciously dish on all things tox. Topics include: how to approach the patient with an unknown overdose, are toxidromes clinically useful, clues on physical exam, is GI decontamination still recommended, and why they hate bupropion and tramadol. We recommend cautious ingestion of fluids while listening because this was a seriously funny episode. Try our Self Assessment Questions Toxicology 101 Quiz. Written and produced by: Christopher Chiu, MD; Graphics by: Beth Garbitelli; Edited by: Matthew Watto, MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.  Time Stamps 00:00 Disclosures 00:35 Intro 01:19 Guest bios both real and sarcastic 04:38 Getting to know our guests 06:33 Multiple choice toxicology 09:13 Book recommendations 11:30 Advice for learners and teachers 15:48 Clinical case from Kashlak Memorial Hospital 16:27 Initial approach and some thoughts on toxidromes 21:59 Physical exam, a toxicologist’s approach 27:09 Review of physiology: anticholinergic, cholinergic, sympathomimetic and how to recognize these findings on exam 34:18 Different speech patterns seen in toxicology 35:30 History taking and how much detective work is truly necessary 40:05 The approach to overdose on multiple substances or in setting of polypharmacy 45:52 Seinfeld, ipecac, and the controversy about gastrointestinal decontamination 63:10 Antidotes and when to give them 67:15 EKGs and overdose. Antidote for long QTc versus wide QRS 71:25 Tramadol and Egypt 73:45 Bupropion and bath salts 78:00 Outro Tags: antimuscarinic, anticholinergic, cholinergic, sympathomimetic, overdose, tramadol, bupropion, quetiapine, wellbutrin, seroquel, pupil, overdose, naloxone, narcar, toxicology, tox, toxidrome, poisoning, gi, decontamination, charcoal, ipecac, antidote, dantastic, howard, ekg, qrs, qtc, bicarbonate, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

The post Bupropion (Wellbutrin) Nursing Pharmacology Considerations appeared first on NURSING.com.

Master the safe and effective use of obesity medications with Endocrinologist, Dr. Karl Nadolsky (co-author of 2016 AACE Obesity guidelines), Director of the Diabetes, Obesity & Metabolic Institute at Walter Reed National Military Medical Center. We get under the hood of each FDA approved obesity medication plus some of our normal hijinks. Check out episode #23 for a more general overview of obesity. Full show notes available at http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Time Stamps 00:00 Intro 03:12 Picks of the week 08:44 Rapid fire questions 13:00 Counsel patients about obesity 14:40 Pathophysiology of obesity 18:00 Case 22:46 Phentermine/topiramate (Qsymia) 26:20 Bupropion/naltrexone (Contrave) 29:18 Liraglutide (Saxenda) 34:32 Orlistat (Alli, Xenical) 37:35 Cost issues 40:18 Lifelong medical therapy for obesity 42:44 Dr. Nadolsky’s take home points 44:45 The Curbsiders recap and discuss their experience with obesity medications 52:28 Outro Tags: assistant, care, doctor, education family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, physician, practitioner, primary, resident, student, obesity, pharmacotherapy, weight loss, safety, side effects, orlistat, alli, naltrexone, bupropion, contrave, phentermine, topiramate, qsymia, lorcaserin, belviq, FDA

We apologize to our listeners for our show being late this week. We are coming to you directly from the Exploring Psychedelics Conference at Southern Oregon University, and preparations and travel have slowed down the release of this week's episode. On Today's Episode of the podcast, Jonathan talks with Jon Bridge. Jon is  a 34 year old father of two. from Canada. The two met through a Facebook Group, The Terence McKenna Experience, thanks to Jon's willingness to share his inspiring story of hope and healing. Jonathan felt called to respond almost immediately after the posting appeared on his feed, and the two connected to share Jon's story. Jon's experience of the failure of standard  psychiatricpharmaceutical drugs  and his journey back to health with the help of psilocybin mushrooms and a clear understanding that the conditions that ailed him for years did not have to be permanent, or simply "managed" with ill-understood collections of molecules. Jon [I was on] daily doses of high strength, high dose pharmaceutical garbage. I was supposed to be a customer for life. Although I have no credentials behind my name I have a story of healing and hope. I had been a long time sufferer of mental illness but thanks to psychedelic medicines I have discovered a new, better self. My journey into psychedelic healing has just begun and I hope to be able to inspire someone to help themselves. Jon's "before" picture, on the let, is dated March 20, 2010, exactly 6 years before the date of his Facebook post..Looking in the eyes, it feels possible to almost see the changed interior landscape behind them. This is a story that our listeners will not want to miss. (None of Jon or Jonathan's remarks should be interpreted as psychiatric advice. Neither is a licensed therapist. Changes in medicines should be done with the partnership of a qualified professional.) Thanks to everyone who "Liked" Psychedelic Parenting on Facebook and helped us reach our goal of 1000 page likes by the end of March. As of 3/31/16 at 11:59pm, we had 1017 page likes! Thanks again to all who clicked, shared or clickshared... And, as always, if you like what you see and hear, please consider a tax-deductible contribution to the work. Help us keep the podcast streaming and the website improving! Click the purple button below to contribute to Psychedelic Parenting via MAPS Click HERE to join our mailing list or become a part of our "Secret" Facebook discussion group. TOPICS AND WEBSITES DISCUSSED IN THIS EPISODE: Exploring Psychedelics Conference Home Page Facebook Page Grateful Meds Dispensary, Talent, Oregon Home Page Oregon Cannabis Connections: "Third Grateful Meds Dispensary Opens in Talent" Pharmeceutical Products Cyprolex (Generic: Escitalopram) Tryptophan Lithium Seroquel (Generic: Quetiapine) Wellbutrin (Generic: Bupropion) Citalopram (Brand Names: Celexa, Cipramil) Divalproex (Valporate) Stopping Psychiatric Drugs  For specific dangers and symptoms and helpful guidelines for coming off psychotropics, see Coming off Psychiatric Medication  Ketamine Erowid.org page WebMD: "Ketamine: The Future of Depression Treatment?" ClinicalTrials.gov: "Rapid Antidepressant Effects of Ketamine in Major Depression" Vice.com: "I Used Ketamine to Treat My Depression" Ketamine Advocacy Network: "Provider Directory" Dextromethorphan ("DXM") Erowid.org: "DXM Vault" Psilocybin Erowid.org: "Psilocybin Mushroom Vault" Vice.com: "What it Feels Like to Treat Depression with Magic Mushrooms" New York Times: "Can Mushrooms Treat Depression?" The New Yorker: "The Trip Treatment" By Michael Pollan Mixing Psilocybin and Cannabis (as Jon describes in his story) Shroomery.org forums: "Cannabis and Mushrooms" Erowid Experience Vaults: "Rendered Eternal, Mushrooms and Cannabis" Santa as Shaman When Santa Was a Shaman: Ancient Origins of Santa Claus and the Christmas Tree  by Tony van Renterghem NPR.org: "Did 'Shrooms Send Santa and his Reindeer Flying?" Reality Sandwich: "Shaman Claus: The Shamanic Origins of Christmas" Plenty of Fish (POF) Free Online Dating Service

Cet enregistrement représente mon interprétation entant qu'étudiant en 2e année de Médecine. Il est fourni entant qu'aide à l'étude et n'a pas comme objectif d'être une ressource primaire. Il ne constitue pas un avis médical. Cet épisode discute les antipsychotiques typiques et atypiques, les antidépresseurs (ISRS, ISNS, iMAO, ATC, Bupropion), les stabilisateurs de l'humeur et les anxiolytiques.