It hurts ... It hurts ... There is not a single person who would not say these words. When something hurts, all other problems go to the background. The most important and most important thing at this moment is to make the discomfort disappear.
Modern pharmacy is ready to offer its customers a huge list of pain medications with a variety of principles of action. One of such medicines is Nalbufin. The instruction regulates it as an agonist and antagonist of opioid receptors, a narcotic analgesic, which is included in the list of the 3rd list of narcotic drugs.
Composition and pharmacodynamics
The main active ingredient of Nalbuphine is nalbuphine hydrochloride. The drug is an analgesic of the opioid group (drugs that have an effect on the human body similar to that of opium). On the principle of action of the drug "Nalbufin", the instructions for use say the following: the main active substance inhibits the transmission of pain impulses between neurons of the nervous system. The drug stimulates the higher parts of the brain, thereby changing the emotional perception of pain.
The effect of Nalbuphine on the human body is comparable to that of Morphine. Nalbuphine hydrochloride stimulates the vomiting center, is able to suppress conditioned reflexes, and has a calming effect. The medication suppresses the center of respiration, but to a much lesser extent than Morphine, Promedol, or Fentanyl.
Release form and dosage regimen
Manufacturers offer their consumers the drug in ampoules "Nalbufin 10" and "Nalbufin 20". In each ampoule - 1 ml of medication. The first ("Nalbufin 10") is packaged in a pack of 10 ampoules, the second - 5. "Nalbufin" (solution) instructions for use, reviews of medical workers are recommended to be prescribed according to a strictly individual scheme, depending on body weight, the severity of pain, accompanying diseases.
The medication can be administered intravenously, intramuscularly or subcutaneously. A single dose for an adult can be from 100 μg to 1 mg per kg of body weight. The initial dose for a child is not more than 300 mcg per 1 kg of body weight. The frequency of use of the drug depends on the overall clinical picture. The treatment course should not last more than 3-4 days, since the drug is narcotic, and with a longer intake, addiction is possible.
Indications for the appointment of "Nalbuphine"
"Nalbufin" instructions for use are recommended for severe pain syndromes, which may be associated with the postoperative period, gynecological surgery, and for the treatment of heart attacks and neoplasms.
Also, the medication is widely used in case of pre-narcotic premedication (preliminary drug preparation of the patient for general anesthesia and surgical intervention). Actually, the main goal of this procedure is to reduce the level of anxiety in the patient and increase the effect of medications for anesthesia. In fact, this is the main area of application of nalbuphine hydrochloride.
Who should refrain from taking?
"Nalbuphine" instructions, reviews and recommendations of experts prohibit taking patients with severe hypersensitivity to the main active ingredient. The use of the medication for the treatment of patients suffering from various diseases of the liver and kidneys is unacceptable. This is due to the fact that Nalbuphine is metabolized in the liver. In its original form, the drug is excreted in the urine (up to 70%), in the form of derivatives it is excreted in the bile.
Do not prescribe a drug for patients with alcohol and drug addiction. Without urgent need, it is not recommended to use the medication to treat children. Since “Nalbuphine” has an effect on the higher centers of the brain, it is not recommended to use it in the treatment of emotionally unstable patients (with psychosis, depression, etc.).
Side effects of Nalbuphine
"Nalbufin", the use of which is due to the narcotic effect on the human body, can cause certain side effects from various systems and organs. So, the cardiovascular system is able to respond to the use of the drug by the development of tachycardia, arrhythmias, fluctuations in blood pressure.
From the side of the nervous system, the appearance of headaches, a strong sedative effect (apathy), euphoria. Such mental manifestations as hyperactivity, increased anxiety are possible. The gastrointestinal tract can remind of itself by the manifestation of dyspepsia (various digestive disorders).
In some cases, the medication "Nalbuphine" (the instructions contain special instructions) can cause a wide variety of allergic reactions ( including anaphylactic shock ).
Well, as mentioned earlier, "Nalbufin" is a narcotic drug, therefore, it can cause rapid addiction.
Excess dose
The dosage of the drug is strictly individual, for each patient the dose is selected depending on the general condition, the severity of pain, weight, etc. Its independent use without the supervision of the attending physician can lead to an overdose of the drug. In this case, as a rule, the following symptoms are observed: depression of the central nervous system, drowsiness, dysphoria (the antonym for “euphoria”, a painfully lowered mood manifested in irritability, hostility to others, ease of manifestation of aggression, in frequent affective outbreaks). Overdose can cause disturbances in the work of the respiratory center.
Treatment consists of using an antidote (for Nalbuphine, as for most opioids, it is Naloxone), gastric lavage, and symptomatic therapy.
To future mothers ...
During pregnancy, “Nalbuphine” can be prescribed only if strict indications are available. With great precautions, a medication is prescribed for premature birth and in cases where there is suspicion of fetal immaturity. Such actions are connected with the fact that “Nalbufin” quite freely overcomes the placental barrier and can provoke respiratory depression in the newborn.
It is also very carefully recommended to use the medication during breastfeeding, although Nalbufin is excreted in mother's milk in small doses that have no clinical significance (less than 1% of the amount of medication administered). Nevertheless, there is no need to endanger the child for no good reason.
Special instructions
The injection solution containing 10 mg / ml nalbuphine hydrochloride (“Nalbuphine Pharmex”), the instruction recommends very careful use in case of impaired respiratory function, since it can reduce the volume of the minute volume of breathing by 25%. Under the supervision of a doctor should be patients taking "Nalbuphine" and at the same time suffering from uremia and a pronounced form of exhaustion, as well as elderly people.
For patients with renal and hepatic insufficiency, the medication is carefully and strictly individually dosed. It is necessary to provide for the possibility of rapid cessation of the administration of Nalbufin for this category of patients.
With precautions, the drug is prescribed for people with skull injuries, since there is a likelihood of a process of respiratory depression. It is highly undesirable to combine the use of "Nalbufin" with other analgesics, due to the possible weakening of the effect of pain relief.
Under constant medical supervision and in reduced doses, the drug is used against the background of drugs for anesthesia, sleeping pills, anxiolytics, antidepressants and antipsychotics. Such a “neighborhood” can provoke excessive depression of the central nervous system and suppression of the activity of the respiratory center.
With caution, "Nalbufin" is prescribed for outpatient use to patients who drive vehicles, or those whose labor activity is associated with the speed of psychomotor reactions.
Price range
The price range is wide enough for the drug "Nalbuphine". Instructions for use, the price of the drug are evidence that the drug is in demand among consumers. Moreover, the analgesic has established itself as an effective drug in medical professionals. It is quite possible to purchase a package of Nalbufin 20 (5 ampoules) in Russian pharmacies for an amount in the range from 620 to 810 rubles. Nalbufin 10 will cost from 650 to 690 rubles (a package of 10 ampoules).
In some pharmacies you can see the sale of "Nalbufin" in a syringe (10 mg / 1 ml), intended for a single injection. The cost of this form of release varies around 160 rubles.
Interaction with other medicines
As mentioned earlier, “Nalbuphine” (this instruction contains information of this kind) together with antidepressants, tranquilizers, antipsychotics, sleeping pills, drugs for anesthesia, antihistamines with sedative effect, ethanol enhances the inhibitory effect on the activity of the central nervous system. The use of an analgesic in parallel with penicillin and phenothiazine derivatives can provoke an increase in nausea and vomiting.
"Naloxone" (antidote) will reduce the effect of exposure to opioid analgesics and, therefore, reduce the process of respiratory depression and central nervous system activity, provoked by "Nalbufin".
"Naltrexone" will significantly accelerate the appearance of withdrawal symptoms against the background of drug addiction ("in all its glory" symptoms may appear as early as 5 minutes after the medication is administered, and will last up to 48 hours). The symptomatology is very persistent, it is quite difficult to eliminate it.
Opinion of consumers and health workers
Patients talk about "Nalbufin" as a fairly effective medication in the period after surgery, for cancer. Although side effects are also common enough and are usually expressed in headaches, drowsiness, apathy, and digestive upsets. According to medical workers, “Nalbuphine” (instructions, composition of the medication, principle of exposure described above) is a good analgesic for fairly serious diseases associated with severe pain.
There is another category of drug users - drug addicts. Here the discussion and reviews come down to the question of whether the action of Nalbuphine and Morphine is similar. From all that this group of consumers says, it can be concluded that the price of Nalbuphine makes the drug attractive for drug users (the instruction is not taken into account by such patients). The drug is cheap (relatively heavy drugs), it can be bought at almost any pharmacy, however, with a prescription. However, according to them, "the buzz is ridiculous, but the breakdowns are real."
From the foregoing, we can conclude that "Nalbufin", of course, is a very effective analgesic. However, it is sold only by prescription - and rightly so. Since the dose and the regimen of use individually selected by the attending physician are the guarantee that the effect of the drug on the patient's body will be positive, and the risk of side effects will be minimal.