Bupropion

Bupropion

Drug monograph · NCLEX study reference
Trade names	Wellbutrin, Zyban
Therapeutic class	Antidepressant, smoking-cessation aid
Pharmacologic class	Norepinephrine-dopamine reuptake inhibitor
Onset / peak / duration	Mood effect over 2 to 4 weeks; ER once daily.
Half-life / level	Half-life about 21 hours; level not routine.
Routes	PO (oral)
High-alert (ISMP)	No
Black box warning	Yes (see Safety)
Antidote / reversal	Supportive care.
Pregnancy / lactation	Use when benefit outweighs risk.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Bupropion (brand names Wellbutrin, Zyban) — Antidepressant, smoking-cessation aid; Norepinephrine-dopamine reuptake inhibitor.

Identification

• Therapeutic class: Antidepressant, smoking-cessation aid.
• Pharmacologic class: Norepinephrine-dopamine reuptake inhibitor.

Pharmacology

• Mechanism of action: Inhibits reuptake of norepinephrine and dopamine; minimal serotonin effect, so little sexual dysfunction.
• Onset / peak / duration: Mood effect over 2 to 4 weeks; ER once daily.
• Half-life / therapeutic level: Half-life about 21 hours; level not routine.

Clinical use

• Indications: Depression, seasonal affective disorder, smoking cessation.
• Usual dose, route, frequency: ER PO once or twice daily.
• Maximum dose / adjustments: Do not exceed dosing limits (seizure risk); reduce in hepatic or renal impairment.

Safety

• Contraindications: Seizure disorder, eating disorders (bulimia or anorexia), abrupt alcohol or sedative withdrawal, MAO inhibitor use.
• Black box warning: Suicidality in those under 25.
• Interactions: Drugs that lower the seizure threshold, MAO inhibitors, CYP2D6 substrates, nicotine patch (blood pressure).
• Pregnancy / lactation: Use when benefit outweighs risk.
• High-alert: No.

Adverse effects

• Common side effects: Insomnia, dry mouth, headache, agitation, weight loss.
• Serious effects to report: Seizures, severe agitation, suicidal thoughts, hypertension.
• Antidote / reversal: Supportive care.

Nursing process

• Assessment before administration: Seizure and eating-disorder history, mood, blood pressure.
• Interventions during therapy: Avoid bedtime dosing (insomnia); respect dose ceilings.
• Monitor: Mood, seizures, blood pressure, weight.
• Evaluation / expected outcome: Improved mood or smoking cessation.

Patient teaching

• Patient teaching: Do not take extra doses; avoid alcohol; can help quit smoking.
• Notify provider if: Any seizure, severe agitation, suicidal thoughts.
• Administration tips: Morning or split dosing; swallow ER whole.