Nubain Issues

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Specializes in NICU.

The L&D nurse manager informed me today that Nubain is NOT a narcotic (or an opioid for that matter), That Narcan is NOT the proper reversal agent for it, and it is not necessary to give an infant narcan in the delivery room even after several episodes of apnea requiring PPV when the mother was medicated with nubain 30 min prior to delivery. I was told it was not basic NRP standards to give narcan in this situation.

Thoughts??

I would sure appreciate some input. :)

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Specializes in NICU.

that was nice of you to post the micromedex link, but you have to have an account to look at whatever you were trying to show me.

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Specializes in Med/Surg, Ortho, ASC.

Try here:

http://www.childbirth.org/articles/nubain.html

BTW, Googling Nubain Narcan brings lots and lots of info.....

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Specializes in Nurse Leader specializing in Labor & Delivery.

Nalbuphine is classified as an opioid analgesic. It's unique in that it's an opioid agonist/antagonist. It can reverse the effects of other opioids (so should be used very cautiously in pt's who have a history of opioid abuse/addiction). Yes, Narcan is the appropriate antidote.

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

I would find some educational material (CEUS) on opiods and their uses in the L & D setting.

Get your information and CEUS at the same time...and maybe alert your resource to the correct information.

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Specializes in Cardiac, Pulmonary, Anesthesia.

I can see why see would be confused. Some agonist/antagonist drugs cannot be reversed with narcan.

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Specializes in ED, ICU, Education.

Oops...sorry about that...I had just assumed. Either way...the antagonist for Nubain according to Micromedix is narcan.

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The information I read on the discussion about Nubain is totally mistaken. I was put on Nalbuphine/Nubain for years. I am not a professional in any capacity. However being an addict for the last 35 years has taught me many things that book learning cannot teach. I am also in recovery from addictions and do not partake in any narcotics or other drugs that effect me from the neck up. My concern is when Nalbuphine is compared to Morphine or other opioids on a mg to mg basis. I have done both drugs as prescribed and eventually to excess. Morphine in excess will kill, as you all know, and I found out by a trip to the ER and a shot of Narcan thank God. I personally shot up one entire bottle of Nubain within 15 minutes and felt no, absolutely NO effect of any kind, not even pain relief or any sort of euphoria, dizziness, sedation, no effect at all. This direct comparison to Morphine/Opioids is complete bull pucky and given by someone who definitely has never used Nubain. Now Morphine on the other hand is a lovely feeling and instant relief of my very severe chronic pain. With Nubain I found no relief for my chronic pain at all. I only noticed relief after I had a tooth ache one time. After a shot of 3ml of Nubain I noticed that my toothache went away, the rest of my pain remained. My injury is from a motorcycle accident. T5-T11 was in the words of the surgeon "pulverized" and now has a large bracket made of titanium for a spine, an L3-L5 laminectomy was done, 7 ribs were broken in 14 places, a lung was punctured, my collar bone now sits about 2 inches higher on the right side than on the left, a severe head injury, and on and on. So, I speak from a great deal of pain experience. Nubain is no answer to chronic pain. Hopefully this may enlighten some people to look into the definitions and effects of Nubain's agonist/antagonist properties and actions on opioids, receptors and other chemicals/drugs.

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Specializes in Labor and Delivery, Newborn, Antepartum.

I've used Narcan per standing orders with an unstable kid following delivery to a mom that received Nubain 45 minutes prior. The second dose of Narcan was given per doctor's verbal order...

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Specializes in Labor and Delivery, Newborn, Antepartum.

And information that I have looked up says it is an opioid and the anectode is Narcan.

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I got report one night on a postpartum mom who was on methadone. The off going nurse had given her nubain for some reason early in the day. I understand it was not pleasant.

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