Nubain question

Oh my. NEVER NEVER NEVER give nubain to a patient who is taking methadone. It causes almost instantaneous withdrawal symptoms...seizures, the whole magilla. It is tough nowadays, when patients aren't so forthcoming with their drug history, and drug testing not a mandatory thing. We had a patient recently who had a history of drug use, and didn't admit to methadone use. When her drug screen came up positive for methadone, she claimed to only "take a bite" out of her brother's methadone once in a while. The doc went ahead and ordered the nubain and she had seizures within minutes of getting the nubain. I guess the nibbles of methadone were more frequent than she cared to admit.

Our pharmacy now puts a note in all of the packaged nubain, to remind us not to give to patient on methadone.

That is a really good idea. I guess it's the same thing as Narcanning the baby, same principle I mean.

I am on 160 MGS. of Methadone and have been clean of opiods for 2 years now. I have migraines, disc fusion in my neck, and fibromyalgia and occassionally will need something for the migraines. I went to an Urgent Care Clinic the other day and had been vomiting for 3 days with a migraine. They didn't ask me about methadone specifically, just the drugs I was on currently and I did not tell them about the methadone. BIG MISTAKE! They gave me a shot of Nubain and Phenergan and within a minute or so I was thrashing about vomiting worse and having diarea. I got the nurse and told her in between vomiting what was happening and they made me sign out and go to another hospital. I thought about going home instead but I thought I would die so I got my son to take me. I felt like there was hot lava running through my veins, my heart was going to burst, and I was spastically moving like Parkinsons disease. I had no control over my body. I kept uncontrollably yelling out also. The ER made me wait awhile before seeing me also and didn't act like it was an emergency. When I did finally see the doctor, he gave me something to calm me down and lower my blood pressure. I will never forget to tell anyone about methadone again! Somehow doctors and nurses need to know the consequenses to help us idiots. I had no bad intentions to get high. I was just sick with a migraine and didn't want the prejudices of the nurses and doctors knowing I was on methadone. I didn't think it was imporant. Doctors don't tell us the importance of not mixing the drugs.

Wow, thank you. I had never heard this before. I will pass this on to all the nurses I work with.
SoCalL&DRN

Thanks for the information. I was not aware of this particular issue. We give stadol most of the time. Any risks associated with giving stadol beyond the normal assessments when giving IV meds?

I had NO idea! Thank you so much for sharing. We do not use Nubain for labor analgesia at my current facility, but we do use it for post op itching. Plus, being a military spouse I know I will end up working at other facilities.

I believe stadol does the same as nubain when giving to methadone/heroin pt's. We have a MD that writes in her standing orders to hold if pt is using.

OP - thanks for starting this thread. In all my yrs working, I had never come across this, and wouldn't have known if I had not seen it here.

Thanks! Anne, RNC