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Chỉ định và Liều dùng
Intravenous
Adjunct in balanced anaesthesia Adult: Induction: 0.3-3 mg/kg over 10-15 min. Maintenance: 0.25-0.5 mg/kg as single admin if required. Parenteral Moderate to severe pain Adult: IM/IV/SC: 10-20 mg 3-6 hrly as required. Non-opioid-tolerant patients: Max single dose: 20 mg. Max daily dose: 160 mg.
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Suy thận
Reduce dose.
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Suy gan
Reduce dose.
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Tương kỵ
Y-site: Allopurinol, amphotericin B cholesteryl sulfate complex, cefepime, docetaxel, methotrexate, nafcillin, piperacillin/tazobactam, pemetrexed, sargramostim, Na bicarbonate. Syringe: Diazepam, dimenhydrinate, ketorolac, pentobarbital.
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Thận trọng
Emotionally unstable patients. Patient w/ MI who exhibit nausea and vomiting, history of opiate abuse, impaired respiration due to other drugs, uraemia, bronchial asthma, severe infection, cyanosis or resp obstruction; about to undergo biliary tract surgery; head injury, intracranial lesions or pre-existing increased intracranial pressure. Renal or hepatic impairment. Pregnancy and lactation.
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Tác dụng không mong muốn
Sedation, dizziness, vertigo, miosis, headache; depression, restlessness, nervousness, crying, drunkenness, euphoria, floating, hostility, confusion, unusual dreams, faintness, feeling of heaviness, tingling, numbness; nausea, vomiting, dry mouth; bradycardia, tachycardia, HTN, hypotension, pulmonary oedema; itching, burning, urticaria; resp depression, dyspnoea, asthma; speech difficulty, urinary urgency, blurred vision, flushing, warmth, sweatiness, clamminess.
Potentially Fatal: Anaphylactic or anaphylactoid and other serious hypersensitivity reactions (e.g. shock, resp distress or arrest, bradycardia, cardiac arrest, hypotension, laryngeal oedema). |
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IM/Parenteral/SC: B (Prolonged use may cause neonatal opioid withdrawal syndrome.
); IV: B (Prolonged use may cause neonatal opioid withdrawal syndrome.) |
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Thông tin tư vấn bệnh nhân
This drug may cause drowsiness and dizziness, if affected, do not drive or operate machinery.
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Chỉ số theo dõi
Monitor relief of pain, resp and mental status, BP.
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Quá liều
Symptoms: Resp depression, CV effects, other CNS effects, sleepiness, mild dysphoria. Management: Supportive treatment. Immediate IV admin of an opiate antagonist (e.g. naloxone or nalmefene) as specific antidote. Admin of oxygen, IV fluids and vasopressors as necessary.
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Tương tác
Additive CNS depressant effects w/ other CNS depressants (e.g. general anaesth, phenothiazines, other tranquilisers, sedatives, hypnotics).
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Tương tác với thức ăn
Additive CNS depression w/ alcohol.
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Tác dụng
Description: Nalbuphine is a phenanthrene derivative w/ mixed opioid agonist and antagonist activity (agonist at kappa opiate receptor; partial antagonist at μ receptor). It inhibits the ascending pain pathways, alters the perception of and response to pain by binding to opiate receptors in the CNS. It also produces generalised CNS depression.
Onset: 2-3 min (IV); <15 min (IM/SC). Duration: 3-6 hr. Pharmacokinetics: Absorption: Time to peak plasma concentration: 30 min (IM). Distribution: Crosses the placenta and distributed in breast milk (small amounts). Plasma protein binding: Approx 50%. Metabolism: Undergoes extensive first-pass metabolism in GI mucosa and liver. Excretion: Via urine and faeces (as unchanged drug and conjugates). Elimination half-life: 5 hr. |
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Đặc tính
 Source: National Center for Biotechnology Information. PubChem Database. Nalbuphine, CID=5311304, https://pubchem.ncbi.nlm.nih.gov/compound/Nalbuphine (accessed on Jan. 22, 2020) |
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Bảo quản
Store between 15-30°C. Protect from light.
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Phân loại MIMS
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Phân loại ATC
N02AF02 - nalbuphine ; Belongs to the class of morphinan derivative opioids. Used to relieve pain.
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Tài liệu tham khảo
Anon. Nalbuphine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 09/11/2015. Buckingham R (ed). Nalbuphine Hydrochloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 09/11/2015. McEvoy GK, Snow EK, Miller J et al (eds). Nalbuphine Hydrochloride. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com
. Accessed 09/11/2015. Nalbuphine Hydrochloride Injection Solution (Hospira, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 09/11/2015.
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