UNIVERSITY OF CEBU - BANILAD

College of Nursing

DRUG STUDY
Patient: ______________A,B.,N.____________________________________________________ _ Age: ____27 years old___ Hospital No.:_________ Room No.:______232-B_______
Impression/Diagnosis: _______________________________________________________________________ Attending Physicians: _______Dr. Roflo____________________________________
Allergy to: ____________None _______________________________________________________________

Generic / Brand Name & Dose, Strength & Indications/Mechanisms of Adverse/Side Effects
Nursing Responsibilities Rationale Client Teaching
Classification Formulation Drug Action Drug Interaction

Generic: Ordered: Indications: Adverse reaction:  Reassess patient's level of pain at  Regular pain assessments at 15 Medication Purpose: Explain
Nalbuphine Nalbuphine 10mg/amp 7 - Adjust a dose (for all - CNS: dizziness, headache, least 15 and 30 minutes after and 30 minutes after parenteral to the client that Nalbuphine is
amp + PNSS gcc give 5cc indications): In patients sedation, vertigo. parenteral administration. a prescription medication
administration help us evaluate
Brand: (5mg) push q8H for 2 dose with renal or hepatic used for the treatment of
Nubain start at 5 pm the effectiveness of the moderate to severe pain. It
impairment, decrease - CV: bradycardia,
dosage. medication, determine its onset belongs to a class of drugs
hypotension.
- Moderate to severe pain and duration of action, and called opioid analgesics.
Classification: Timing: (non-opioid-tolerant - EENT: dry mouth monitor for any adverse effects.
5pm, 1am patients). Adjust dosage This information guides our Administration: Instruct the
Therapeutic Class: according to the severity decision-making in pain client on the appropriate
- GI: nausea, vomiting.
Opioid Analgesics Duration: of pain, physical status, method of administration,
management, ensuring that
Q8H and other drugs patient is which is typically through
Pharmacologic Class: - Respiratory: respiratory patients receive appropriate and injection given by a healthcare
receiving.
Opioid Agonist-Antagonist- depression. timely interventions. professional. Emphasize that
- Adjunct to balanced
Opioid Partial Agonists Other forms: Nalbuphine should only be
anesthesia; preoperative - Skin: Clamminess,
Injection 10mg/mL, administered by a trained
and postoperative
20mg/mL diaphoresis healthcare provider in a
analgesia; obstetric
 Careful monitoring of vital signs, healthcare setting.
analgesia during labor
and delivery.  Carefully monitor vital signs, pain pain level, respiratory status, and
Side Effects: level, respiratory status, and Dosage and Frequency:
sedation level in all patients
May interfere with sedation level in all patients Inform the client that the
enzymatic methods for receiving opioids, especially those
receiving opioids, especially those dosage and frequency of
detection of opioids. receiving IV drugs, is essential for Nalbuphine will be determined
Mechanism of Action: receiving IV drugs, even those given
postoperatively. ensuring patient safety, by their healthcare provider
Unknown. Binds with
Drug Interaction: optimizing pain management, based on their specific pain
opioid receptors in the
detecting respiratory depression, management needs.
CNS, altering
- Benzodiazepines, CNS and addressing any adverse Emphasize the importance of
perception of and
depressants, opioids: May following the prescribed
emotional response to effects promptly. This
cause respiratory dosage and not exceeding the
pain. comprehensive monitoring
depression, profound recommended limits.
sedation, coma, and death. approach supports effective
Avoid use together. opioid administration and Pain Relief Expectations:
- If use together is mitigates potential risks Explain that Nalbuphine is
necessary, limit dosage associated with opioid therapy. intended to provide pain relief,
and duration of each drug but it may not completely
to minimum necessary for eliminate all pain. Discuss that
desired effect. Monitor the medication aims to reduce
patient response closely.  Assessing a patient's risk of opioid the intensity of pain, allowing
- CNS depressants, general the client to perform daily
abuse, misuse, and addiction
anesthetics, hypotics, MAO  Before starting drug, assess activities more comfortably.
before initiating opioid therapy,
inhibitors, sedatives, patient's risk of opioid abuse,
 tranquilizers, TCAs: May misuse, and addiction. Regularly and regularly monitoring for the Side Effects: Educate the
cause respiratory monitor patients for development of development of these behaviors client about the possible side
depression, HTN, profound these behaviors or conditions. or conditions, is vital for patient effects of Nalbuphine. These
sedation, or coma. Use may include nausea, vomiting,
together with caution and safety, prevention of addiction, dizziness, drowsiness,
monitor patient response. early intervention, optimizing pain constipation, and itching.
- Naltrexone: May result in management, and complying with Inform them that not everyone
opioid withdrawal signs and regulatory requirements. These experiences these side
symptoms and decreased practices help healthcare effects, and they should
opioid effectiveness. Avoid providers make informed contact their healthcare
combination. provider if they become
decisions about opioid therapy
bothersome or persistent.
and ensure that patients receive
appropriate care while minimizing Safety Precautions: Highlight
the risks associated with these the importance of informing
medications. healthcare providers about
any allergies, medical
conditions, or other
medications the client is
 Signs and symptoms may occur taking, including over-the-
Alert: If patient is taking opioids with within several hours of counter drugs and
serotonergic drugs, watch for signs and coadministration but may also supplements. Nalbuphine may
symptoms of occur later, especially after interact with certain
serotonin syndrome (agitation, dosage increase. Discontinue medications, and it is crucial
hallucinations, rapid HR, fever, excessive opioid, serotonergic drug, or both to ensure its safe use.
sweating, shivering or if serotonin syndrome is
shaking, muscle twitching or stiffness, suspected. Avoid Alcohol and CNS
trouble with coordination, nausea, Depressants: Advise the client
vomiting, diarrhea), to avoid consuming alcohol or
especially at start of therapy and after using other central nervous
dosage increase. system (CNS) depressant
 If adrenal insufficiency is medications while taking
Alert: Monitor patient for signs and confirmed, treat with Nalbuphine. Combining these
symptoms of adrenal insufficiency corticosteroids and wean patient substances can increase the
(nausea, vomiting, off opioids if appropriate. risk of sedation, respiratory
loss of appetite, fatigue, weakness, Discontinue corticosteroids when depression, and other serious
dizziness, low BP). Perform diagnostic clinically appropriate. side effects.
testing if adrenal
insufficiency is suspected Provide guidance on storing
 If signs and symptoms occur, Nalbuphine securely, away
Alert: Monitor patient for signs and evaluate patient and obtain lab from children and pets, in a
symptoms of decreased sex hormone testing cool and dry place. Inform the
levels (low libido, client about proper disposal
erectile dysfunction, amenorrhea, methods, such as returning
infertility). any unused medication to a
. designated collection site or
 To prevent signs and symptoms
following local regulations.
of withdrawal, worsening pain,
Alert: Don’t stop drug abruptly; withdraw
and psychological distress in
slowly and individualize the gradual Encourage the client to attend
physically dependent patients.
tapering plan. follow-up appointments as
Refer to manufacturer’s label for
When tapering opioids, monitor patient scheduled to assess the
specific tapering instructions.
closely for signs and symptoms of opioid effectiveness of the
withdrawal (restlessness, lacrimation, medication. Inform them that it
rhinorrhea, yawning, perspiration, chills, is important to reach out to
myalgia, their healthcare provider with
mydriasis, irritability, anxiety, insomnia, any concerns, questions, or
backache, joint pain, weakness, unexpected reactions to the
 abdominal cramps, medication.
anorexia, nausea, vomiting, diarrhea,
increased BP or HR, increased
respiratory rate), which may
indicate a need to taper more slowly. Also
monitor patient for suicidal thoughts, use
of other
substances, and mood changes.
Drug acts as an opioid antagonist and
may cause withdrawal syndrome. For
patients who have
received long-term opioids, give 25% of
the usual dose initially. Watch for signs of
withdrawal.

• Look alike–sound alike: Don't confuse

Nubain with Navane or Nebcin. Don't  Avoiding confusion about a
confuse nalbuphine with naloxone. medication and its uses is
essential for patient safety,
optimal treatment outcomes,
adherence to the prescribed
regimen, effective communication
with healthcare providers, and
informed decision-making. It
promotes safe and appropriate
medication use, reducing the risk
of errors, adverse effects, and
potential harm to patients.
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