Week 5 Flashcards by Robert Soncini

Nalbuphine (Nubain)

Class

Opiod Analgestic

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Nalbuphine (Nubain)

Mechanism of Action

Activates opioid receptor in the limbic system of the CNS

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Nalbuphine (Nubain)

Indication

moderate to severe acute pain.

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Nalbuphine (Nubain)

Contraindications

Head injury or undiagnosed abdominal pain, diarrhea caused

by poisoning, hypovolemia, and hypotension.

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Nalbuphine (Nubain)

Drug Interactions

CNS depressants may potentiate the effects.

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Nalbuphine (Nubain)

Adult

2 – 5 mg slow IV; may repeat 2 mg doses PRN to a maximum dose of 10 mg.

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Nalbuphine (Nubain)

Pediatric

Pediatric Dose

Not Recommended

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Nalbuphine (Nubain)

Onset

2-3 minutes

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Nalbuphine (Nubain)

Peak Effect

variable

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Nalbuphine (Nubain)

Duration

3-6 hours

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Nalbuphine (Nubain)

Special Considerations

Use with caution in patients with impaired respiratory function.
May precipitate withdrawal syndromes in narcotic-addicted patients.
Naloxone should be readily available.

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Morphine Sulfate
(Astramorph)
Class

Opioid analgesic

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Morphine Sulfate
(Astramorph)
Mechanism of Action
Brain

Alleviates pain through CNS action, suppresses fear and anxiety centers of the brain; depresses brain stem respiratory centers,

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Morphine Sulfate
(Astramorph)
Indications

Severe CHF, pulmonary edema, chest pain associated with an acute MI, analgesia for moderate to severe acute and chronic pain.

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Morphine Sulfate
(Astramorph)
Contraindications

Head injury, exacerbated COPD, depressed respiratory drive, hypotension. Undiagnosed abdominal pain, decreases level of consciousness, suspected hypovolemia, patients who taken MAOIs in the last 14 days.

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Morphine Sulfate
(Astramorph)
Drug Interactions

Potentiates the sedative effects of phenothiazines

- CNS depressant may potentiate the effects of morphine. -MAOIs may cause paradoxical excitation.

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Morphine Sulfate
(Astramorph)
Dosage and Administration
Adult

Initial dose: 2 – 5 mg IV (over 1 – 5 minutes). Repeat dose: 2 mg every 2 minutes titrated to effect.
5-15 mg IM based on patients weight

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Morphine Sulfate
(Astramorph)
Dosage and Administration
Pediatric

0.1 – 0.2 mg/kg with a maximum dose of 5 mg, IV, IM, IO, or SC.

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Morphine Sulfate
(Astramorph)
Onset

Onset

Immediate

Morphine Sulfate
(Astramorph)
Peak Effect

Peak Effect

20 Minutes

Morphine Sulfate
(Astramorph)
Duration

Duration

2-7 hours

Morphine Sulfate
(Astramorph)
Special Considerations

Use with caution in the geriatric population and those with COPD, asthma. Vagotonic effect in patients with an acute inferior MI, Naloxone should be readily available.

Nitrous Oxide

Class

Gaseous analgesic and anesthetic

Nitrous Oxide

Mechanism of Action

Exact mechanism is unknown; affects central nervous system phospholipids.

Nitrous Oxide | Indications

Moderate to severe pain, anxiety, apprehension.

Nitrous Oxide | Contraindications

Impaired level of consciousness, head injury, inability to follow instructions, decompression sickness, undiagnosed abdominal pain or marked distension, bowel obstruction, hypotension, shock, COPD (with history of CO2 retention), and chest trauma with pneumothorax.

Nitrous Oxide | Drug Interactions

None of Significance

Nitrous Oxide Dosage and Administration Adult

Instruct patient to inhale deeply through demand valve mouthpiece or mask.

Nitrous Oxide Dosage and Administration Pediatric

Instruct patient to inhale deeply through demand valve mouthpiece or mask.

Nitrous Oxide | Onset

2-5 Minutes

Nitrous Oxide | Peak Effect

Variable

Nitrous Oxide | Duration

2-5 Minutes

Nitrous Oxide | Special Considerations

Increases the risk of spontaneous abortion. Nitrous oxide is ineffective in 20% of the population.

Nalbuphine (Nubain) Mechanism of Action Chest Pain

may be preferred in chest pain in setting of an acute MI as it reduces the myocardial oxygen demand without reducing the BP.

Nalbuphine (Nubain) Mechanism of Action Properties

Agonist and Antagonist

Nalbuphine (Nubain) Mechanism of Action Analgesic Actions

Analgesic similar to morphine on a milligram for milligram basis

Morphine Sulfate (Astramorph) Mechanism of Action Heart

increases peripheral venous capacitance and decreases venous return, decreases preload and afterload, which decreases myocardial oxygen demand.

apnea, cyanosis, dizziness are side adverse reactions of this drug?

Nitrous Oxide

drowsiness, euphoria, malignant hyperthermia are side adverse reactions of this drug?

Nitrous Oxide

nausea, vomiting are side adverse reactions of this drugs?

Nitrous Oxide, Morphine Sulfate | Astramorph

Respiratory depression, hypotension are side adverse reactions of this drug or drugs?

Morphine Sulfate | Astramorph), Nalbuphine (Nubain

bradycardia, tachycardia, syncope are side adverse reactions of this drug or drugs?

Morphine Sulfate | Astramorph

facial flushing, euphoria, bronchospasm, and dry mout are side adverse reactions of this drug or drugs?

Morphine Sulfate | Astramorph

decreased level of consciousness is a side adverse reactions of this drug or drugs?

Nalbuphine (Nubain)

paradoxical CNS stimulation, CNS depression are side adverse reactions of this drug or drugs?

Nalbuphine (Nubain)

blurred vision, bradycardia, euphoria, facial flushing are side adverse reactions of this drug or drugs?

Nalbuphine (Nubain)