The Poison Lab

Mini Episode: Bridging the Gap- Bupropion's not your average wide QRS with Dr. Travis Olives

Episode Summary

In this episode Ryan is Joined by Dr. Travis Olives MD (Associate medical director of Minnesota Poison Center, Medical Toxicologist, Emergency Physician) to discuss the implications of bupropion's effect on gap junctions and its apparent lack of effect on sodium channel, when managing wide QRS arrythmias in bupropion overdose

Episode Notes

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