Buprenorphine

Details About Generic Salt ::  Buprenorphine 

Main Medicine Class:: Nervous System   Sub Medicine Class ::  Opioid Analgesics

1I. OPIOID ANALGESICS in 1. NERVOUS SYSTEM
BUPRENORPHINE
OPIOID AGONIST-ANTAGONIST | ANALGESIC
also comes under 16C. Miscellaneous in 16. Anesthetics
PK: A: Rapid (IM) D: 97-187 L/kg (Vd) M: Hepatic E: Urine, feces

Indications & Dose: BALANCED ANAESTHESIA IM Adult 300µg | OPIOID DEPENDENCE SL Adult 0.8-4mg/day, MD 32mg/day | PAIN Moderate-to-severe SL Adult 200-400µg repeated q6-8h as needed Child 16–25 kg: 100µg q6-8h, 25–37.5 kg: 100-200µg q6-8h, 37.5–50 kg: 200-300µg q6-8h, >50 kg: 200-400µg q6-8h | Moderate-to-severe IV/IM Adult 300-600µg repeated q6-8h as required Child 6 months-12 yr: 3-6µg/kg q6-8h, max 9µg/kg, 12-18 yr: 300-600µg q6-8h Elderly 0.15mg q6h | Chronic TD Adult Initially 5µg/h once weekly (in opioid-naive patients/those receiving morphine PO <30mg/day) or 10µg/h once weekly (patients receiving morphine PO 30-80mg/day) | PERIOPERATIVE ANALGESIC SUPPLEMENT IV Adult 300-450µg

Contra: Hypersensitivity, TD patch (Significant respiratory depression), severe asthma, known/suspected paralytic ileus, management of mild, acute/intermittent pain, pain requiring short-term opioid analgesia, postoperative pain

Precautions: Intracranial pressure, respiratory impairment, severe renal/hepatic/pulmonary disease, hypothyroidism, adrenal insufficiency, undiagnosed abdominal pain, prostatic hypertrophy, SLE, gout, kyphoscoliosis, DM, alcoholism, elderly, children <13 yr

ADR: Serious: bradycardia, tachycardia, respiratory depression, hypotension, convulsions, rhabdomyolysis, palpitations, Raised ICP, Others: muscle rigidity, ureteric/biliary spasm, orthostatic hypotension, hypothermia, restlessness, mood changes, decreased libido/potency, hallucinations, miosis, euphoria, nausea, vomiting, constipation, drowsiness, confusion, dry mouth, dizziness, sweating, facial flushing, headache, vertigo

DDI: Serious Amitriptyline enhances respiratory depressant effect, Ketoconazole/HIV protease inhibitors increases drug level, Methadone/Fentanyl/Morphine precipitates opioid withdrawal symptoms, Phenobarbital/Carbamazepine/Phenytoin reduces drug efficacy

Monitor: Respiratory & mental status, CNS depression, BP, LFTs, withdrawal symptoms, application site reactions (transdermal patch)

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