Bain

BainNalbuphineNalbuphine

10mg/1ml10mg/1ml

華宇藥品股份有限公司

高啟峰 [email protected]

Nubain

Bain

非管制麻醉用藥

唯一非管制的麻醉藥品

How to control

Pain

Nacortic

NSAIDs

Morphine

Fentanyl

Demerol

Tramadol

Ketorolac

• 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.

Bain injectionN a l b u p h i n e H C l

MuMu ReceptorReceptor

Agonist

Morphine

Fentanyl Pethidine

Antagonist

Bain

Lower respiratory depression

Kappa ReceptorKappa Receptor

Weak Agonist

Morphine

Agonist

Bain

Duration(hours)

Recommended DosageRecommended Dosage

55--10mg10mg0.1mg/kg

Adverse reactionsAdverse reactions

Sedations(36%)Sedations(36%) Sweaty/clammy(9%)Sweaty/clammy(9%) Nausea(6%)Nausea(6%) Dizziness/vertigo(5%)Dizziness/vertigo(5%) Dry mouth(4%)Dry mouth(4%) Headache(3%)Headache(3%)

Established Clinical Profile in Pain Management

Slightly lowers cardiac workload Slightly lowers cardiac workload 99--1111Cardiovascular Effect

““Ceiling EffectCeiling Effect””7,87,8Respiratory Depressant Effect

33--6 6 hours (Plasma thours (Plasma t1/21/2 = 5 hr)= 5 hr)Duration of Analgesia

22--3 3 minutes IVminutes IVOnset of Action

55--10 mg10 mg (0.1 mg/kg; 10 mg/1 ml)(0.1 mg/kg; 10 mg/1 ml)Recommended Dose

IM, IV, SCIM, IV, SCRoute of Administration

Moderate to severe painModerate to severe painSupplement to balanced anesthesiaSupplement to balanced anesthesiaPrePre--op and postop and post--op analgesiaop analgesiaObstetrical analgesia during labor and Obstetrical analgesia during labor and deliverydelivery**

Indication

Bain (nalbuphine Bain (nalbuphine HClHCl) .) .Features


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


Safety and Efficacy in a broad spectrum of Clinical Settings:

Added Comfort to Patients

Post-Operative Setting: Minimal Respiratory Depression Faster Onset and Long-acting Analgesia Lower Incidence of GI Distress A Very Low Incidence of Nausea/Vomiting

Treatment for Morphine-induced Pruritus Treatment for Post-op Shivering Maintenance of Analgesia while Treating

Morphine-induced Adverse Effects


•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.


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.

• 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% CO2

- 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.

Reference (II) - Gastrointestinal

BainBain包裝規格包裝規格

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

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Bain

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