Prototype Drug Unit 1 & 2 Exam- Buprenorphine With Naloxone (suboxone, Zubsolv) Flashcards
What is the classification of buprenorphine?
Therapeutic: drug for treating opioid addiction, narcotic analgesic
Pharmacologic: opioid agonist-antagonist
What are the therapeutic effects and uses?
It is a Schedule 3 when given IM/IV
It is given by the sublingual route 3 to 4 times per week.
It reduces the cravings of opioids in opioid dependent patients.
What are the Mechanisms of Action?
It occupies mu receptors in the brain and dorsal horn of the spinal cord kinda like opioid agonists do. (In other words they act kinda like opioids) THe Naloxone competes with opioid agonists for the mu and kappa receptors, thus antagoinizing the effects of morphine and other opioids.
What is the Route of the drug?
Sublingual (administered under the tongue); tablets or oral film
How well is the drug absorbed?
It varies (Buprenorphine well absorbed; naloxone poorly absorbed)
How is the drug distributed?
It binds to plasma protein (96% buprenorphine, 45% naloxone); crosses the placenta; and is secreted in brest milk
Where is it primarily metabolized?
Hepatically (in the liver)
How is it primarily excreted?
Renal (30%) and feces (69%)
What are the adverse effects of the drug?
headache, nausea, vomiting, hyperhidorsis (abnormally excessive sweating that’s not necessarily related to heat or exercise), constipation, insomnia, pain, and peripheral edema.
What are the contraindications/precautions of the drug?
It is contraindicated in patients that are hypersensitive to either buprenorphin or naloxone. Naloxone should be used with caution in patients with cardiovascular disease. Naloxone may also precipitate seizures in patients with seizure disorders.
What are the drug interactions of this drug?
An additive sedation will occur if it is taken with other narcotic analgesics and CNS depressants. Do not mix with benzodiazepines. Should not be taken with alvimopan (Entereg)
What is the pregnancy category of this drug?
Category C
What is the treatment of overdose of this drug?
Buprenorphine overdose can cause coma, hypotension, and life-threatening respiratory depression, and requires immediate treatment. Additional naloxone doses are indicated to reverse the opioid intoxication
What are the nursing responsibilities with this drug?
1) Assess the patient (Obtain a complete health history and drug history. Obtain a dietary history. Asses level of pain. Obtain baseline vital signs and weight.)
2) Reasses (Assess the patient’s commitment to the treatment. Check to see if there is the desired. therapeutic effects. Monitor the hepatic functions. Recheck vital signs, especially blood pressure and pulse. Check for and report adverse effects)
3) Ensure that the therapeutic effects are working
4) Monitor vital signs to see if there are any adverse effects
5) Monitor for changes in behavior, including depression, hostility, agitation, or thoughts of suicide.
6) Monitor for skin rashes and facial or throat edema
7) Help the patient to understand the drug therapy. (Talk about the therapeutic outcomes, commonly observed adverse effects, parameters for when to call the health care provider, and any necessary monitoring or precautions.
8) Instruct the patient, family, or caregivers how to give proper self-admistration of the drug.
