Classification: OPIOID ANALGESICS GENERIC NAME (nalbuphine hydrochloride) BRAND NAME Nubain DOSE 5mg through IV INDICATION NUBAIN

(nalbuphine hydrochloride) is indicated for the relief of moderate to severe pain. NUBAIN (nalbuphine hydrochloride) can also be used as a supplement to balanced anesthesia for preoperative and pos toperativeanalgesia and for obstetrical analgesia during labor and delivery. ACTION Binds to opiate receptors in the !N" alters the perception of and responses to painful stimuli #hile producing generali$ed !N" depression. CONTRAINDICATI ON !ontraindica ted in patients hypersensitive to drug Use cautiously in patients #ith history of drug abuse and in those #ith emotional instability head in%ury increased I!& impaired ventilation 'I accompanied by N(V upcoming biliary surgery and hepatic or renal disease. PRECAUTION/ ADVERSE REACTION )CNS* "edation di$$iness vertigo headache agitation confusion crying depression dysphoria euphoria faintness floating feeling hallucinations heaviness feeling hostility nervousness numbness restlessness sei$ures tingling unreality unusual dreams )CV* Bradycardia hypertension hypotension tachycardia )EENT* Blurred vision dry NURSING CONSIDERATI ON )+eassess patient,s level of pain at least -5 and ./ minutes after parenteral administration )Nalbuphine acts as an opioid antagonist and may cause #ithdra#al syndrome. 0or patients #ho have received log1term opioids give 253 of the usual dose initially. 4atch for sings of #ithdra#al. )Alert* 5rug

mouth )GI* Nausea vomiting biliary tract spasms constipation cramps dyspepsia )GU* Urinary urgency )R s!i"ato"#: +espiratory depression asthma dyspnea pulmonary edema

causes respiratory depression #hich at -/mg is e6ual to respiratory depression produced by -/ mg of morphine )'onitor circulatory and respiratory status bladder and bo#el function. If respirations are shallo# or rate is belo# -2 breaths(minute #ithhold dose and notify prescriber )!onstipation is often severe #ith maintenance therapy.