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NUBAINE
Drug Class:
Narcotic agonist-antagonist analgesic
Therapeutic Actions:
Nalbuphine acts as an agonist at specific opioid receptors in the CNS to produce
analgesia, sedation but also acts to cause hallucinations and is an antagonist at
receptors
Indications:
Contraindications/cautions:
Dosages:
Available Forms:
Injection 10 mg/ml, 20mg/ml
Adults:
Usual dose is 10 mg/70kg, SC, IM or IV q 3-6h as necessary.
Individualize dosage. In nontolerant patients, the recommended single
maximum dose is 20mg, with a maximum total daily dose of 160mg.
Patients dependent on narcotics may experience withdrawal symptoms.
Pediatric patients < 18 yr : Not recommended
Geriatric patients or patients with renal or hepatic impairment: Reduce dosage
Pharmacokinetics:
Route
IV
SC/IM
Onset
2-3 min
< 15 min
Peak
15-20 min
30-60 min
Metabolism: hepatic, T : 5 hr
Distribution: Crosses placenta, enters breast milk
Excretion: Urine
IV facts
Duration
3-6 hr
3-6 hr
Contraindications/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, prostatic
hypertrophy, CV disease or hypertension, breast cancer, thyrotoxicosis,
pregnancy, children, a child with history of sleep apnea, a family history of
SIDS, or Reyes syndrome, the elderly,.
Dosages:
Available Forms:
Tablets 12.5,25,50 mg;
Syrup 6.25,25mg/5ml
Suppositories 12.5,25,50 mg
Injection- 25,50 mg/ml
Adults:
Allergy Average dose is 25 mg PO or by rectal suppository, preferably
hs. 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 -1hr
before travel; repeat in 8-12 hr if necessary. Thereafter, give 25 mg on
arising 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. 12.5-25
mg 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 dose
of 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, 25-75
mg with a reduced dose of narcotic. May repeat once or twice at 4-hr
intervals. Maximum dose within 24 hr is 100 mg.
Pharmacokinetics
Route
Onset
Oral
IM
IV
20 min
20 min
3-5 min
Duration
12 hr
12 hr
12 hr