Nalbuphine Reviewed by Momizat on . Generic  Name: Nalbuphine Brand Name:  Nubain Classification: Opioid analgesic Mode of Action: Depresses pain impulse transmission at the spinal cord level by i Generic  Name: Nalbuphine Brand Name:  Nubain Classification: Opioid analgesic Mode of Action: Depresses pain impulse transmission at the spinal cord level by i Rating:
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Nalbuphine

Generic  Name: Nalbuphine

Brand Name:  Nubain

Classification: Opioid analgesic

Mode of Action:

Depresses pain impulse transmission at the spinal cord level by interacting with opioid receptors.

Binds with opiate receptors in the CNS: ascending pain pathways in limbic system, thalamus, midbrain, hypothalamus, altering perception of and emotional response to pain.

Indication:

Symptomatic relief of moderate to severe pain. Also preoperative sedation analgesia and as a supplement to surgical anesthesia.

Contraindication:

History of hypersensitivity to drug. Safety during pregnancy (category c) or lactation is not established.  Addiction (opiate)

Side Effects: 

CNS: drowsiness, dizziness, confusion, headache, sedation, euphoria, hallucinations, dreaming

CV: palpitations, bradycardia, change in BP, orthostatic hypotension, cardiac arrest

GI: nausea, vomiting, anorexia, constipation, abdominal pain, dyspepsia, bitter taste

Urogenital: urinary urgency

Respiratory: dyspnea, respiratory depression

Drug Interactions:

Avoid use with MAOIs, unpredictable reactions may occur. Increases effects with other CNS depressants – alcohol, opiates, sedative/hypnotics, skeletal muscle relaxants.

Nursing Responsibilities:

  1. Raise bed rails.
  2. Obtain vital signs before giving medication. If respirations are ≤12/min (≤20/min in children),withhold medication, contact physician.
  3. Assess onset, type, location, duration of pain. Effect of medication is reduced if full pain recurs before next dose. Low abuse potential.
  4. Monitor for change in respirations, BP/rate/quality of pulse.
  5. Monitor pattern of daily bowel activity, stool consistency.
  6. Initiate deep breathing, coughing exercises, particularly in patients with impaired pulmonary function.
  7. Assess for clinical improvement, record onset of relief of pain.
  8. Avoid driving a car or operating machinery because nubain is associated with sedation and may impair mental and physical abilities required for the performance of potentially dangerous tasks such as this.
  9. Reassess patient’s level of pain at least 15 and 30 minutes after parenteral administration.
  10.  Constipation is often severe with maintenance therapy. Make sure stool softener or other laxative is ordered.
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