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Published by sweetpixie18

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Published by: sweetpixie18 on Feb 22, 2010
Copyright:Attribution Non-commercial


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Drug Class:Narcotic agonist-antagonist analgesicTherapeutic Actions:Nalbuphine acts as an agonist at specific opioid receptors in the CNS to produceanalgesia, sedation but also acts to cause hallucinations and is an antagonist at µreceptorsIndications:
Relief of moderate to severe pain
Preoperative analgesia, as a supplement to surgical anesthesia, and for obstetric analgesia during labor and delivery.Contraindications/cautions:
Contraindications: hypersensitivity to nalbuphine, sulfites; lactation.
Use cautiously with emotionally unstable clients or those with a history of narcotic abuse; pregnancy prior to labor, labor or delivery, bronchialasthma, COPD, respiratory depression, anoxia, increased intracranialpressure, acute MI when nausea and vomiting are present, biliary tractsurgery.Dosages:Available Forms:Injection – 10 mg/ml, 20mg/mlAdults:Usual dose is 10 mg/70kg, SC, IM or IV q 3-6h as necessary.Individualize dosage. In nontolerant patients, the recommended singlemaximum dose is 20mg, with a maximum total daily dose of 160mg.Patients dependent on narcotics may experience withdrawal symptoms.Pediatric patients < 18 yr : Not recommendedGeriatric patients or patients with renal or hepatic impairment: Reduce dosagePharmacokinetics:
IV2-3 min15-20 min3-6 hSC/IM< 15 min30-60 min3-6 hMetabolism: hepatic, T ½: 5 hr Distribution: Crosses placenta, enters breast milkExcretion: UrineIV facts
Preparation: No additional preparation is required.Infusion: Administer by direct injection or into the tubing of a running IV, each 10mg over 3-5 min.V-site incompatibilities: Do not give with nafcillinAdverse Effects:
Sedation. Clamminess, sweating headache, nervousness, restlessness,depression, crying, confusion, faintness, hostility, unusual dreams, hallucinations,euphoria, dysphoria, unreality, dizziness, vertigo, floating feeling, feeling of heaviness,numbness, tingling, flushing, warmth, blurred vision.
Hypotension, Hypertension, bradycardia, tachycardia
Itching, burning, urticaria
Nausea, vomiting, cramps, dyspepsia, bitter taste, dry mouth
Urinary urgency
Respiratory depression, dyspnea, asthma
Drug class:Phenothiazine, Dopaminergic bloking agent, Antihistamine, Antiemetic, Anti-motion sickness agent, Sedative/hypnotic.Therapeutic Actions:Selectively blocks H1 receptors, diminishing the effects of histamine on cells of the upper respiratory tract and eyes and decreasing the sneezing, mucus production,itching and tearing that accompany allergic reactions in sensitized people exposed toantigens; blocks cholinergic receptors in the vomiting center that are believed to mediatenausea and vomiting caused by gastric irritation, by input from the chemoreceptor trigger zone; depress the RAS, including the parts of the brain involves in wakefulness.Indications:
Symptomatic relief of perennial and seasonal allergic rhinitis, vasomotor rhinitis, allergic conjunctivitis; mild, uncomplicated urticaria andangioedema; amelioration of allergic reactions to blood or plasma;dermatographism, adjunctive theraphy.
Treatment and prevention of motion sickness; prevention and control of nausea and vomiting associated with anesthesia and surgery.
Preoperative, postoperative or obstetric sedation.
Adjunct to analgesics to control postoperative pain.
Adjunctive IV therapy with reduced amounts of meperidine or other narcotic analgesics in special surgical situations, such as repeatedbronchoscopy, ophthalmic surgery or in poor-risk patientsContraindications/cautions:
Contraindications: hypersensitivity to antihistamines or phenothiazines,coma or severe CNS depression, bone marrow depression, vomiting of unknown cause, concomitant therapy with MAOIs, lactation.
Use cautiously with lower respiratory tract disorders, glaucoma, prostatichypertrophy, CV disease or hypertension, breast cancer, thyrotoxicosis,pregnancy, children, a child with history of sleep apnea, a family history of SIDS, or Reye’s syndrome, the elderly,.Dosages:Available Forms:Tablets – 12.5,25,50 mg;Syrup – 6.25,25mg/5mlSuppositories – 12.5,25,50 mgInjection- 25,50 mg/mlAdults:Allergy – Average dose is 25 mg PO or by rectal suppository, preferablyhs. If necessary,12.5 mg PO before meals and hs; 25 mg IM or IV for serious reaction.May repeat within 2 hr if necessary.Motion sickness – 25mg PO bid. Initial doses should be scheduled ½-1hr before travel; repeat in 8-12 hr if necessary. Thereafter, give 25 mg onarising and before evening meal.Nausea and vomiting – 25mg PO; repeat doses of 12.5-25mg as needed,q4-6hr. give rectally or parenterally if oral dosage is not tolerated. 12.5-25mg IM or IV, not to be repeated more frequently than q4-6hr.Sedation: 25-50 mg PO, IM, IV.Preoperative use: 50 mg PO the night before, or 50mg with an equal doseof meperidine and the required amount of belladonna alkaloid.Postoperative sedation and adjunctive use with analgesics: 25-50 mg PO,IM or IV.Labor: 50mg IM or IV in early stages. When labor is established, 25-75mg with a reduced dose of narcotic. May repeat once or twice at 4-hr intervals. Maximum dose within 24 hr is 100 mg.

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