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Nalbuphine is a synthetic agonist-antagonist opioid which has been introduced to clinical used for over 40 years. It antagonized µ2-opioid receptor while antagonized k-opioid receptor. Thai FDA has approved the use of nalbuphine for a treatment of moderate to severe pain. Opioid induced pruritus, which caused by the mu-opioid receptor activation can be effectively treated by nalbuphine, because nalbuphine is an antagonist to mu-opioid receptor. In Thai FDA does not categorized nalbuphine as not narcotics or controlled substances. There for, it more feasible to the clinical use when compare to other opioids. This collective review aims to summarize mechanism of action, pharmacology, efficacy, safety and evidence based clinical studies of nalbuphine for the benefit of anesthesiologists and general practitioners.
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