Bupivacain

A Drug Study Presented to

Lendell Kelly B. Ytac, RN
Faculty, INAHS BSN-Program
Davao Oriental State University

_____________________________________________

In Partial Fulfillment
of the requirements for
NCM 118
Care of Clients with Life Threatening Conditions, Acutely Ill / Multi-Organ Problems,
High Acuity and Emergency Situations

By

Clint S. Ancog
Student Nurse, BSN-4

October 12, 2022

 Name of Drug Dosage/ Mechanism of Indication Contraindication Side Effects/ Nursing
Frequency/ Action Adverse Effects Responsibilities
Time/ Route
Generic Name: Infiltration Pharmacokinetics: Bupivacaine, Known sensitivity SIDE EFFECTS: Assessment &
Bupivacain Anesthesia Onset: 4-17 min alone or in to bupivacaine,  Burning, Drug Effects
(epidural, caudal, combination local anesthetics, crawling,
Brand Name: Adult: IM local peripheral, or with and other amide- itching, Monitor for signs
 Marcaine infiltration, ssympathetic block) epinephrine, type anesthetics. numbness, of inadvertent
sympathetic ; within 1 min is indicated in Parabens, or prickling, "pins intravascular
Drug block 0.25% (spinal block) adults for the metabisulfites; and needles", or injection, which
Classification: solution; Lumbar Duration: 3-5 hours production of acidosis; heart tingling feelings. can produce a
 Bupivacaine epidurl 0.25%, (epidural, caudal, local or block; severe  change or loss of ransient
belongs to a 0.5%, 0.75% peripheral, or regional hemorrhage, taste. “epinephrine
group of drugs solutions; Caudal sympathetic block); anesthesia or uncontrolled  chest pain or response”
called local block, peripheral 1.25-2.5 hours analgesia for coagulopathy; discomfort. (increased heart
anesthetics. nerve block (spinal block) surgery, hypotension and  continuing rate or systolic
These work by 0.25%, 0.5% Distribution: dental and shock; ringing or BP or both,
numbing one solutions; Crosses placenta oral surgery hypertension, buzzing or other circumoral pallor,
small area of Retrobulbar Metabolism: In procedures, cerebrospinal unexplained palpitations,
the body block 0.75% liver diagnostic and diseases; noise in the ears. nervousness)
(local) or solution Elimination: 6% therapeutic obstetrical  decrease in the within 45 seconds
blocking pain unchanged in urine procedures, paracervical frequency and in the unsedated
in an area of Child: IM 1-3.7 and for anesthesia or ptient and an
amount of urine.
the body mg/kg Pharmacodynamic obstetrical spinal anesthesia increase in heart
 difficult or
(regional). s: procedures. in septicemia; rate for at least 15
painful urination.
Anesthetic of the topical or IV seconds in
Chemical make-up  increased thirst.
amide type that regional sedated patient.
and effect: decreases sodium anesthesia;
flux into nerve cell, intercurrent use Vasoconsstrictor-
ADVERSE
Like lidocaine, inhibiting initial with cpntaining
EFFECTS:
bupivacaine is an depolarization, and chloroprocaine; solution should be
amino-amide prevents history of The mean seizure administered
anesthetic; the propagation and malignant dosage of cautiously, if at
aromatic head and
the hydrocarbon conduction of the hyperthermia; bupivacaine in all, to areas with
chain are linked by nerve impulse. pregnancy rhesus monkeys was end arteries, or to
an amide bond Progression of (category C) found to be 4.4 areas with
rather than an ester anesthesia, related mg/kg with mean comopromised
as in earlier local to diameter, arterial plasma blood supply;
anesthetics. As a myelination, and concentration of 4.5 ischemia and
result, the amino- conduction velocity mcg/mL. The gangrene can
amide anesthetics of affected fibers is intravenous and result.
are more stable manifested subcutaneous LD 50
and less likely to clinically as in mice is 6 to 8 Note systemic
cause allergic sequential loss of mg/kg and 38 to 54 reactions
reactions. nerve function. mg/kg respectively. (toxicity) are
Primary depressant Recent clinical data more apt to occur
effect is in the from patients in children or
medulla and higher experiencing local older adults and
centers affecting anesthetic induced may develop
patient’s reaction to convulsions rapidly after 30
pain, temperature, demonstrated rapid mins of
and touch, as well development of administration.
as proprioception hypoxia,
and skeletal muscle hypercarbia, and
tone. acidosis with Patient & family
bupivacaine within a Education
minute of the onset
of convulsions. After spinal
anesthesia,
sensation to lower
extremeties may
not return for 2.5-
3.5 hours.
References:

Skidmore-Roth L. (2021). MOSBY’S 2021 NURSING DRUG REFERENCE, ISBN: 978-0-323-75733-1THIRTY-FOURTH

EDITION. 3251 Riverport Lane. St. Louis, Missouri 63043

Kizior R. J., & Hodgson K. J. (2021). Saunders Nursing Drug Handbook 2021. Elsevier. 3251 Riverport Lane. St. Louis, Missouri
63043.