Name

nabuphine (Nubain®)

Class

Opioid analgesic

Narcotic agonist-antagonist

Description/Mechanism

Synthetic narcotic analgesic with agonist and weak antagonist properties. Analgesic potency is approximately equal to that of morphine at equivelant doses. On a weight basis, produces roughly the same level of respiratory depression as morphine but, unlike morphine, doses > 30 mg produce no further depression. antagonistic potency is approximately 1/4 that of naloxone.

Onset

2-3 minutes

Duration

3-6 hours

Indications

Chest pain associated with myocardial infarction

Moderate to severe acute pain.

May be necessary in some chronic pain syndromes.

Pulmonary edema, with or without associated pain (morphine is first-line medication in this class)

Contraindications

Hypersensitivity to narcotics

Hypovolemia

Hypotension

Head injury or undiagnosed abdominal pain

Adverse Reactions

Hypotension

Bradycardia

Facial flushing

Respiratory depression

CNS depression

Euphoria

Paradoxical CNS stimulation

Blurred vision

Drug Interactions

CNS depressants may potentiate effects

Supplied

10 mg in 1 ml ampule

20 mg in 1 ml ampule

Dose/Administration

Adult

IV: 2-5 mg slow push; may be augmented with 2 mg doses prn

Pediatric

Not recommended.

Special Consideration

Pregnancy Safety: Category B

Use with caution in patients with impaired respiratory function

Has a weak narcotic antagonist effect and may precipitate withdrawal syndrome in narcotic-dependent patients

Naloxone should be readily available