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.
Symptomatic relief of moderate to severe pain. Also preoperative sedation analgesia and as a supplement to surgical anesthesia.
History of hypersensitivity to drug. Safety during pregnancy (category c) or lactation is not established. Addiction (opiate)
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
Avoid use with MAOIs, unpredictable reactions may occur. Increases effects with other CNS depressants – alcohol, opiates, sedative/hypnotics, skeletal muscle relaxants.
- Raise bed rails.
- Obtain vital signs before giving medication. If respirations are ≤12/min (≤20/min in children),withhold medication, contact physician.
- Assess onset, type, location, duration of pain. Effect of medication is reduced if full pain recurs before next dose. Low abuse potential.
- Monitor for change in respirations, BP/rate/quality of pulse.
- Monitor pattern of daily bowel activity, stool consistency.
- Initiate deep breathing, coughing exercises, particularly in patients with impaired pulmonary function.
- Assess for clinical improvement, record onset of relief of pain.
- 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.
- Reassess patient’s level of pain at least 15 and 30 minutes after parenteral administration.
- Constipation is often severe with maintenance therapy. Make sure stool softener or other laxative is ordered.