Generic/ Trade name

nalbuphine hydrochloride

Dosage/ Frequency
2 mg

Classification
Opioid analgesics

Indication
Nalbuphine is indicated for the relief of moderate to severe pain. It can also be used as a supplement to balanced anesthesia, for preoperative and postoperative analgesia, and for obstetrical analgesia during labor and delivery. Although Nalbuphine possesses narcotic antagonist activity, there is evidence that in nondependent patients it will not antagonize a narcotic analgesic administered just before, concurrently, or just after an injection. Therefore, patients receiving a narcotic analgesic, general anesthetics, phenothiazines, or other tranquilizers,

Contraindication
NUBAIN should not be administered to patients who are hypersensitive to nalbuphine hydrochloride, or to any of the other ingredients in NUBAIN.

Side Effect
The most frequent side effect in 1066 patients treated with nalbuphine was sedation in 381 (36%). Other, less frequent reactions are: feeling sweaty/clammy 99 (9%), nausea/vomiting 68 (6%), dizziness/vertigo 58 (5%), dry mouth 44 (4%), and headache 27 (3%). Other adverse reactions which may occur (reported incidence of 1% or less) are: CNS effects: Nervousness, depression, restlessness, crying, euphoria, floating, hostility, unusual dreams, confusion, faintness, hallucinations, dysphoria, feeling of heaviness, numbness, tingling, unreality. The incidence of psychotomimetic effects, such as unreality, depersonalization, delusions, dysphoria and hallucinations has been shown to be less than that which occurs with pentazocine.

Nursing Responsibilities
-Taper dosage when discontinuing after prolonged use to avoid withdrawal symptoms. -Keep opioids antagonist and facilities for assisted or controlled respiration readily available in case of respiratory depression. -Reassure patient liability; most patients who receive opiates for medical reasons do not develop dependence syndrome.

sedatives, hypnotics, or other CNS depressants (including alcohol) concomitantly with Nalbuphine may exhibit an additive effect. When such combined therapy is contemplated, the dose of one or both agents should be reduced.

Cardiovascular: Hypertension, hypotension, bradycardia, tachycardia, pulmonary edema. Gastrointestinal: Cramps, dyspepsia, bitter taste. Respiration: Depression, dyspnea, asthma. Dermatological: Itching, burning, urticaria. Obstetric: Pseudosinusoidal fetal heart rhythm.

Other possible, but rare side effects include speech difficulty, urinary urgency, blurred vision, flushing and warmth.

Generic/ Trade name

Dosage/ Frequency
8 to 16 mg three times daily

Classification
Anti emetics and Anti vertigo

Indication
Symptomatic treatment of the vertigo associated with Mnires Syndrome.

Contraindication
Hypersensitivity to any of the ingredients. Patients with active peptic ulcer. Patients with phaeochromocytoma.

Side Effect
Gastro-intestinal disturbances, headache and skin rashes have been reported. Special precautions Caution should be exercised when betahistine dihydrochloride is given to patients with a history of peptic ulcer or asthmatic patients. Concomitant use with antihistamines should be avoided. There is insufficient data on the use of this medicine during pregnancy and lactation.

Nursing Responsibilities
Instruct patient that drug should be taken with food. Patients with phaechromocytoma or bronchial asthma should be treated with extra care.

Generic/ Trade name

Dosage/ Frequency
2-10 mg given 2-4 times daily.

Classification
Antianxiety agents, anticonvulsants, sedative/hyptonics, skeletal muscle relaxants

Indication
is a prescription medicine commonly used for the treatment of anxiety. It is not intended for treating "everyday anxiety" and is recommended only for short-term use.Themedication can also be used to relieve symptoms associated with alcohol withdrawal, treat muscle spasms due to cerebral palsy or other disorders, and stop seizures (when used along with other seizure medications).

Contraindication
Hypersensitivity - Cross-sensitivity with other benzodiazepines may occurs - Comatose patients - Pre-existing CNS depression - Uncontrolled severe painUse cautiously in: 1) Hepatic dysfunction 2) Severe renal impairment 3) History of suicide attempt or drug dependence

Side Effect
- CNS: 1) dizziness 2) drowsiness 3) lethargy 4) hangover 5) headache 6) depression - EENT: 1) blurred vision - RESP: 1) respiratory depression - CV: 1) hypotension - GI: 1) constipation 2) diarrhea 3) nausea 4) vomiting - DERM: 1) rashes - LOCAL: 1) pain (IM) 2) phlebitis (IV) 3) venous thrombosis - MISC: 1) physical & psychological depen-dence 2)tolerance

Nursing Responsibilities
-Monitor BP, PR,RR prior to periodically throughout therapy and frequently during IV therapy. - Assess IV site frequently during administration, diazepam may cause phlebitis and venous thrombosis. - Prolonged high-dose therapy may lead to psychological or physical dependence. Restrict amount of drug available to patient. Observe depressed patients closely for suicidal tendencies. - Observe and record intensity, duration and location of seizure activity. The initial dose of diazepam offers seizure control for 1520 min after administration. - IM injections are painful and erratically absorbed. If IM route is used, inject deeply into deltoid muscle for maximum

absorption. - Caution patient to avoid taking alcohol or other CNS depressants concurrently with this medication. - Effectiveness of therapy can be demonstrated by decrease anxiety level; control of seizures; decreased tremulousness.