Crushing bupropion

[trishm74]

Hi, all.

I am a former psych nurse and I'm curious about the practice of crushing bupropion ir in correctional facilities, which I understand is fairly common. I have spoken to one manufacturer thus far who recommends that even their ir formulation not be crushed, however it is not in their literature. Understandably I think we all assume that if a medication is 'regular' release we assume that it can be crushed. The issue that I'm concerned about is that there are several inmates at a local facility complaining of complications that they had not had prior to taking the medication crushed, from nausea right up to seizures. What have you all experienced?

[dlynn34LPN]

I also work at a correction where they want us to crush all psych meds and narcs... I do crush the narcs but rarely the psych cause most psych meds are more potent and some should not be crushed..i have had complaints from inmates that the medicine does not work the same but none with those side effects. But i will say wellburtion (bupurion) think im spelling those wrong is a med i dont crush

[trishm74]

Thank you. And good for you! I guess some of the nurses try to just break the Wellbutrin but the facility is coming down on them for it. I understand that there is abuse potential with inmates snorting Wellbutrin, but from what I've gotten for feedback from people who have snorted it, the effects are similar to what the guys who need it are experiencing for side effects. I think it's sad that nurses are being asked to do something that is detrimental to their patients. Maybe my attitude is off but inmates or not, they're still patients, and still human beings; quality of care shouldn't be sacrificed.

If I can ask you another question- does your facility routinely do mouth checks?

[dlynn34LPN]

Yes I treat inmates like patients but some other nurses dont.. And yes if i dont crush i do mouth checks and have them blow. But it is not required.

[trishm74]

Thank you!

[Orca, ADN, ASN, RN]

We have done away with crushing altogether. While I understand the arguments for it, by crushing the medication you are altering the absorption rate, and in effect giving the inmate a bolus of medication.