Document Detail


Therapeutic monitoring of nalbuphine: transplacental transfer and estimated pharmacokinetics in the neonate.
MedLine Citation:
PMID:  8706774     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Nalbuphine, a mixed agonist-antagonist opiate, is commonly used as a systemic analgesic during labour. Recent reports of perinatal adverse effects prompted us to carry out therapeutic nalbuphine monitoring in obstetric analgesia. Because data on fetomaternal transfer are scarce and the pharmacokinetics of this drug in the neonate are largely unknown, we report data obtained from 28 parturients treated with nalbuphine either intramuscularly and/or intravenously during labour. Plasma nalbuphine levels were measured by high-performance liquid chromatography (HPLC) with electrochemical detection. At delivery, 30-150 min after maternal administration, nalbuphine concentrations ranged from 5.0 to 79.2 ng.ml-1 in mother plasma samples and from 3.0 to 46.6 ng.ml-1 in umbilical cord plasma samples. Nalbuphine concentrations were highly correlated to dose. The fetomaternal ratio was high: 0.74 and not correlated to the administered dose of nalbuphine. An estimated plasma half-life of 4.1 h was calculated from two determinations in the neonate based on the assumption of a monoexponential decay of nalbuphine concentrations. Apart from a flattening of the fetal heart rate tracing in 54% of the cases, only one neonate had a low Apgar score at birth. The apparent prolonged half-life of nalbuphine in the neonate indicates the usefulness of an intramuscular injection of naloxone to prevent recurrence of cardiorespiratory depression due to nalbuphine administration to the mother.
Authors:
E Nicolle; P Devillier; B Delanoy; C Durand; G Bessard
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of clinical pharmacology     Volume:  49     ISSN:  0031-6970     ISO Abbreviation:  Eur. J. Clin. Pharmacol.     Publication Date:  1996  
Date Detail:
Created Date:  1996-09-09     Completed Date:  1996-09-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1256165     Medline TA:  Eur J Clin Pharmacol     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  485-9     Citation Subset:  IM    
Affiliation:
Laboratoire de Pharmacologie, Centre Hospitalier Universitaire de Grenoble, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Analgesia, Obstetrical
Analgesics, Opioid / administration & dosage,  blood*,  pharmacology
Apgar Score
Chromatography, High Pressure Liquid
Female
Fetal Blood / chemistry
Half-Life
Humans
Infant, Newborn / metabolism*
Injections, Intramuscular
Injections, Intravenous
Maternal-Fetal Exchange*
Nalbuphine / administration & dosage,  blood*,  pharmacokinetics
Placenta / metabolism*
Pregnancy
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 20594-83-6/Nalbuphine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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