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Topic: Nubain (Read 584 times) |
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UN solved
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Nalbuphine (Nubain) 10mg injections. 
Just wondering if anyone has any experience with this drug ... ??
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ClusterChuck
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Re: Nubain
« Reply #1 on: Mar 20th, 2007, 5:05pm » |
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Sorry, buddy, that is a new one to me ...
Chuck
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BB
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Re: Nubain
« Reply #2 on: Mar 20th, 2007, 6:25pm » |
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Nalbuphine (nalbuphine hydrochloride) is a synthetic opioid used commercially as an analgesic under a variety of trade names, including Nubain. It is noteworthy in part for the fact that at low dosages, it is found much more effective by women than by men, and may even increase pain in men, leading to its discontinuation in the UK in 2003.
Clinical Pharmacology
Nalbuphine is a synthetic narcotic agonist-antagonist analgesic of the phenanthrene series. It is chemically related to both the widely used narcotic antagonist, naloxone, and the potent narcotic analgesic, oxymorphone. It is available in two concentrations, 10 mg and 20 mg of nalbuphine hydrochloride per mL. Both strengths contain 0.94% sodium citrate hydrous, 1.26% citric acid anhydrous, 0.1% sodium metabisulfite, and 0.2% of a 9:1 mixture of methylparaben and propylparaben as preservatives; pH is adjusted, if necessary, with hydrochloric acid. The 10 mg/mL strength contains 0.1% sodium chloride.
Nalbuphine is also available in a sulfite and paraben-free formulation in two concentrations, 10 mg and 20 mg of nalbuphine hydrochloride per mL. One mL of each strength contains 0.94% sodium citrate hydrous, 1.26% citric acid anhydrous; pH is adjusted, if necessary, with hydrochloric acid. The 10 mg/mL strength contains 0.2% sodium chloride.
Nalbuphine is a potent analgesic. Its analgesic potency is essentially equivalent to that of morphine on a milligram basis. Its onset of action occurs within 2 to 3 minutes after intravenous administration, and in less than 15 minutes following subcutaneous or intramuscular injection. The plasma half-life of nalbuphine is 5 hours and in clinical studies the duration of analgesic activity has been reported to range from 3 to 6 hours.
The narcotic antagonist activity of Nalbuphine is one-fourth as potent as nalorphine and 10 times that of pentazocine.
Indication
Nalbuphine is indicated for the relief of moderate to severe pain. It can also be used as a supplement to balanced anesthesia, for preoperative and postoperative analgesia, and for obstetrical analgesia during labor and delivery.
Although Nalbuphine possesses narcotic antagonist activity, there is evidence that in nondependent patients it will not antagonize a narcotic analgesic administered just before, concurrently, or just after an injection. Therefore, patients receiving a narcotic analgesic, general anesthetics, phenothiazines, or other tranquilizers, sedatives, hypnotics, or other CNS depressants (including alcohol) concomitantly with Nalbuphine may exhibit an additive effect. When such combined therapy is contemplated, the dose of one or both agents should be reduced.
Dosing
The usual recommended adult dose is 10 mg for a 70 kg individual, administered subcutaneously, intramuscularly or intravenously; this dose may be repeated every 3 to 6 hours as necessary. Dosage should be adjusted according to the severity of the pain, physical status of the patient, and other medications which the patient may be receiving. In non-tolerant individuals, the recommended single maximum dose is 20 mg, with a maximum total daily dose of 160 mg.
The use of NUBAIN as a supplement to balanced anesthesia requires larger doses than those recommended for analgesia. Induction doses of NUBAIN range from 0.3 mg/kg to 3.0 mg/kg intravenously to be administered over a 10 to 15 minute period with maintenance doses of 0.25 to 0.50 mg/kg in single intravenous administrations as required.
In case of overdose or adverse reaction, the immediate intravenous administration of naloxone (Narcan) is a specific antidote. Oxygen, intravenous fluids, vasopressors and other supportive measures should be used as indicated.
Side Effects
The most frequent side effect in 1066 patients treated with nalbuphine was sedation 381 (36%).
Other, less frequent reactions are: feeling sweaty/clammy 99 (9%), nausea/vomiting 68 (6%), dizziness/vertigo 58 (5%), dry mouth 44 (4%), and headache 27 (3%). Other adverse reactions which may occur (reported incidence of 1% or less) are:
CNS EFFECTS: Nervousness, depression, restlessness, crying, euphoria, floating, hostility, unusual dreams, confusion, faintness, hallucinations, dysphoria, feeling of heaviness, numbness, tingling, unreality. The incidence of psychotomimetic effects, such as unreality, depersonalization, delusions, dysphoria and hallucinations has been shown to be less than that which occurs with pentazocine.
CARDIOVASCULAR: Hypertension, hypotension, bradycardia, tachycardia, pulmonary edema.
GASTROINTESTINAL: Cramps, dyspepsia, bitter taste.
RESPIRATION: Depression, dyspnea, asthma.
DERMATOLOGICAL: Itching, burning, urticaria.
Other possible, but rare side effects include speech difficulty, urinary urgency, blurred vision, flushing and warmth.
I am not familiar with it and havent seen it used in a GP practice. Its similar to other narcotics.
For IV it takes a few mins to work, for IM or SC it takes up to 15 mins to work, so I am wondering if it is fast acting enough to make a real difference for CH pain ? Also its interesting that its more effective in women than in men ? And that it may even increase pain in men?
Annette
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ClusterChuck
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Re: Nubain
« Reply #3 on: Mar 20th, 2007, 7:08pm » |
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Two things scare me with Annette's information ...
(1) it is an opiate
(2) it may increase the pain in men.
It is your choice, of course, but I would be leary of it. But then again, it may be your silver bullet!
Good luck, and let us know how it works, if you decide to try it.
Chuck
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BB
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Re: Nubain
« Reply #4 on: Mar 20th, 2007, 7:40pm » |
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This got me curious about gender differences in the effectiveness of Nubain, so I looked further and found this article:
The kappa opioid nalbuphine produces gender- and dose-dependent analgesia and antianalgesia in patients with postoperative pain
by
Gear RW, Miaskowski C, Gordon NC,
Paul SM, Heller PH, Levine JD
Center for Orofacial Pain,
University of California,
San Francisco 94143, USA
Pain 1999 Nov; 83(2):339-45
ABSTRACT
Nalbuphine, pentazocine, and butorphanol, mixed agonist/antagonist opioids that induce analgesia by acting predominantly at kappa opioid receptors, have recently been shown in single-dose studies to have greater analgesic efficacy in women than in men. In the current experiments, the first placebo controlled dose response study of opioid analgesic efficacy that examines for gender differences, nalbuphine (5, 10, or 20 mg) and placebo were evaluated in 62 men and 69 women for the treatment of moderate to severe postoperative pain following extraction of impacted wisdom teeth. In a randomized, open injection, double blind experimental design, pain intensity was recorded on a 10 cm visual analog scale (VAS) immediately prior to drug administration (baseline) and at 20 min intervals thereafter. Although responses to placebo were similar in men and women, for all doses of nalbuphine women exhibited significantly greater analgesic response than men, compatible with our previous results. Unexpectedly, men receiving the 5 mg dose of nalbuphine experienced significantly greater pain than those receiving placebo; only the 20 mg dose of nalbuphine in men produced significant analgesia compared to placebo. While a similar antianalgesic effect was not observed in women, only the 10 mg dose of nalbuphine produced significant analgesia compared to placebo. These results suggest that the optimal analgesic dose of nalbuphine for women is lower than the highest dose that can be safely administered. In contrast, the antianalgesic effect of nalbuphine suggests avoidance of its routine use for postoperative analgesia in men until further studies clarify this issue. Because gender differences in other mixed kappa agonists/antagonists (i.e. pentazocine and butorphanol) have previously been shown, these results may generally apply to this class of opioid analgesics.
It appears that because it acts on the kappa receptors which has a gender difference that it produces different results in males than females. Very interesting, I didnt know that!
Annette
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Tara Ann
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Re: Nubain
« Reply #5 on: Mar 21st, 2007, 2:50pm » |
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I got it when I was in labor with Sammie and it didn't do a damn thing but make it hard to keep my eyes open and zap more of my energy that was soooo very much needed.
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Superpain
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Re: Nubain
« Reply #6 on: Mar 21st, 2007, 3:26pm » |
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Before I found this place, O2 or anything else, the only thing that ever helped was stadol. It sounds pretty similar except stadol is 7 times stronger than morphine.
I wouldn't reccomend it as a long term solution and it didn't always work. But there were times that it did work to abort, and it would almost always take the edge off the headache and make it considerably more bearable.
I think nalbuphine, and I know naloxone, are used in treatment for opiate addiction like methadone is.
Have you used it Unsolved?
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Chris
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Yes, I've used Stadol many times ( both the nasal spray and the injections). Stadol had just lost it's effectiveness and I didn't like the nasty taste it left me with either. I wanted to try something different so they gave me Nubain vials. I'll give it a try.
UNsolved
Thanks everyone for your responses 
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lionsound
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Re: Nubain
« Reply #8 on: Mar 23rd, 2007, 1:09am » |
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I'm pretty sure i got a shot of that once in the ER for my noggin...knocked me out, but my head still hurt.
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gore2424
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Re: Nubain
« Reply #9 on: Mar 23rd, 2007, 6:04am » |
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I used to get the 20mg nubain shots with 50mg of a anti depression/ anti nausea drug called and i might not spell it right vilisteral when ever i went to ER and at one time had 10 of both per month but when I got on the pain patches It was too much so now i get 12 per month of the 10mg morphine shots for the bad days or nites Terry
stadol had been the only drug i took myself off of i abused it i would first open it up and put 1/3 water in it just so it would last longer and i could use it more than was to i loved the rush i got and would lie just to get a bottle a week where it should lasted a month Terry
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what the hamsalad was that ¿?¿
I said your hair looks nice Ü
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