Nalbuphine HCl

A to Z Drug Facts

Nalbuphine HCl

  Action
  Indications
  Contraindications
  Route/Dosage
  Interactions
  Lab Test Interferences
  Adverse Reactions
  Precautions
Patient Care Considerations
  Administration/Storage
  Assessment/Interventions
  Patient/Family Education


(NAL-byoo-FEEN HIGH-droe-KLOR-ide)
Nubain
Class: Narcotic agonist-antagonist analgesic

 Action An opiate analgesic with both narcotic agonist and antagonist actions. Analgesic potency is about equal to that of morphine, and antagonist potency is about 1/25 that of naloxone. May cause sphincter of Oddi spasm. Does not increase pulmonary artery pressure, systemic vascular resistance or myocardial work load.

 Indications Management of moderate-to-severe pain; preoperative and postoperative analgesia; supplement to balanced anesthesia; obstetrical analgesia during labor and delivery.

 Contraindications Standard considerations.

 Route/Dosage

ADULTS: SC/IM/IV 10 mg/70 kg q 3 to 6 hr prn. Individualize dosage. In nontolerant patients, do not exceed 20 mg/dose or 160 mg/day.

 Interactions

CNS depressants, including barbiturate anesthetics: Increased respiratory and CNS depression. Incompatibilities: Diazepam, pentobarbital, promethazine.

 Lab Test Interferences None well documented.

 Adverse Reactions

CV: Hypertension; hypotension; bradycardia; tachycardia; pulmonary edema. CNS: Sedation; dizziness; vertigo; headache. DERM: Urticaria. EENT: Miosis. GI: Nausea; vomiting; constipation; dry mouth. RESP: Respiratory depression. OTHER: Sweaty or clammy feeling.

 Precautions

Pregnancy: Pregnancy category undetermined. Safety (except during labor) is unknown. May cause respiratory depression in neonate; use drug with caution in women delivered of premature infants. Lactation: Undetermined. Children: Not recommended in patients < 18 yr. Special-risk patients: Use drug with caution in patients with impaired respiration, head injury, increased intracranial pressure, or MI with nausea or vomiting and in patients about to undergo biliary tract surgery. Dependence: Low abuse potential; however, withdrawal symptoms can occur after long-term use. Use drug with caution in patients who are emotionally unstable or have history of narcotic abuse. Opiate-dependent patients: Nalbuphine can precipitate withdrawal; small doses of morphine can be given to relieve discomfort. If patient has received morphine, meperidine, codeine or other opiate of similar duration, give 25% of normal nalbuphine dose first. Observe for signs of withdrawal and increase nalbuphine dose slowly. Renal or hepatic impairment: Duration of action may be prolonged; may need to reduce dose. Sulfite sensitivity: Contains sodium metabisulfite, which may cause allergic-type reactions including anaphylactic symptoms and life-threatening asthma.


PATIENT CARE CONSIDERATIONS


 Administration/Storage

 Assessment/Interventions

OVERDOSAGE: SIGNS & SYMPTOMS
  Respiratory depression, hypoxemia, sedation

 Patient/Family Education

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Copyright
© 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts