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  1. 1. Bain Nalbuphine 10mg/1ml 華宇藥品股份有限公司 高啟峰
  2. 2. Nubain Bain 非管制麻醉用藥
  3. 3. 唯一 非管制的麻醉藥品
  4. 4. How to control Pain
  5. 5. Morphine Fentanyl Nacortic Demerol Tramadol NSAIDs Ketorolac
  6. 6. Bain injection Nalbuphine HCl • Kappa-agonist/mu-receptor antagonist analgesic1 – Faster onset and long-acting , Potent analgesic – Minimal respiratory depression – Lower incidence of post-OP ileus, constipation, biliary spasm, and pruritus – Lower incidence of euphoria and morphine-like dependence – Lower incidence of nausea and vomiting Reference: 1. Schmidt WK, Tam SW, Shotzberger GS, Smith DH, Clark R, Vernier VE. Nalbuphine. Drug and Alcohol Dependence. 1985;14:339-362.
  7. 7. Mu Receptor Morphine Bain Agonist Antagonist Lower respiratory depression Fentanyl Pethidine
  8. 8. Kappa Receptor Morphine Bain Agonist Weak Agonist
  9. 9. Duration(hours)
  10. 10. Recommended Dosage 5-10mg 0.1mg/kg
  11. 11. Adverse reactions  Sedations(36%)  Sweaty/clammy(9%)  Nausea(6%)  Dizziness/vertigo(5%)  Dry mouth(4%)  Headache(3%)
  12. 12. Bain injection Established Clinical Profile Nalbuphine HCl in Pain Management Features Bain (nalbuphine HCl) HCl) . Indication Moderate to severe pain Supplement to balanced anesthesia Pre-op and post-op analgesia Pre- post- Obstetrical analgesia during labor and delivery* Route of Administration IM, IV, SC Recommended Dose 5-10 mg (0.1 mg/kg; 10 mg/1 ml) Onset of Action 2-3 minutes IV Duration of Analgesia 3-6 hours (Plasma t1/2 = 5 hr) Respiratory Depressant Effect “Ceiling Effect”7,8 Effect” Cardiovascular Effect Slightly lowers cardiac workload 9-11
  13. 13. Bain injection Nalbuphine HCl Safety and Efficacy in a broad spectrum of Clinical Settings: Added Comfort to Patients Recovery Room:  Rapid Return to Spontaneous Respiration and Full Consciousness  Adequate Post-operative Ventilation  Cardiovascular Stability  Very Low Incidence of Nausea/Vomiting  Shorter Stay in the Recovery Room
  14. 14. Bain injection Nalbuphine HCl Safety and Efficacy in a broad spectrum of Clinical Settings: Added Comfort to Patients Post-Operative Setting:  Minimal Respiratory Depression  Treatment for Morphine-induced Pruritus  Faster Onset and Long-acting Analgesia  Treatment for Post-op Shivering  Lower Incidence of GI Distress  Maintenance of Analgesia while Treating  A Very Low Incidence of Nausea/Vomiting Morphine-induced Adverse Effects
  15. 15. Bain injection Nalbuphine HCl • Safety and Efficacy in a Broad Spectrum of Clinical Settings Emergency Room* • Rapid onset – within 2 to 3 minutes IV, less than 15 minutes IM or SC. • Favorable haemodynamic profile compared to that of morphine.9 • Concomitant use may produce an additive effect with other narcotics, tranquilizers, and sedatives. Reference: 9. Lee G, Low RI, Amsterdam EA, DeMaria AN, Huber PW, Mason DT. Haemodynamic effects of morphine and nalbuphine in acute myocardial infarction. Clinical Pharmacology and Therapeutics. 1981;29(5):576-581. *. Maintain patient under observation until recovered from Nubain effects. Nubain may impair mental or physical abilities required for the performance of potentially dangerous tasks such as driving a car or operating machinery.
  16. 16. Reference (I) - Respiratory depression • Clin Pharmacol Ther 1980 Apr; 27(4): 478-485 • Ceiling effect for respiratory depression by nalbuphine • Narcotic antagonist analgesic: nalorphine (X), nalbuphine - lower abuse liability - ceiling effect for respiratory depression - potency comparable to that of morphine • Maximum respiratory depression occurred at 30 mg/70 kg. • The ceiling effect for respiratory depression by nalbuphine provides a unique safety factor among potent analgesics.
  17. 17. Reference (II) - Gastrointestinal • Br J Anaesth 1987; 59: 581-584 • Recovery of bowel motility after surgery • Clinical indication of the return of coordinated bowel motility following surgery is the passage of flatus • Flatus: 5-80% CO 2 - Carbon dioxide analyzer to note the time to first flatus (TFF) • Nalbuphine, Placebo (NS), morphine • The median TFF: - Bain vs. Placebo: 212 min: 64 min (3 times) - IM Bain vs. morphine: 5.65 h: 11.84 h • Nalbuphine will have considerably less adverse effect on recovery of bowel function than morphine.
  18. 18. Bain包裝規格 中文品名:芯奔 英文品名:Bain Injection 10Amps/box 劑型 :注射液 成分 :nalbuphine HCl 10mg/ml 適應症: 解除中度到嚴重疼痛,也可作為平衡 麻醉的輔助劑。如手術前後之止痛, 及在分娩陣痛過程中的產科止痛 健保價: 52元/Amp
  19. 19. Thanks for your kindness