Evaluation of new analgesics. Butorphanol and nalbuphine

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Abstract
Two new strong analgesics, butorphanol tartrate and nalbuphine hydrochloride, have recently become available. The pharmacologic actions of these mixed agonist-antagonist-type analgesics resemble those of pentazocine lactate, but the relative agonist and antagonist potencies of the drugs differ. They are effective analgesics in moderate to severe pain associated with conditions for which morphine or other opiates are used. The most commonly reported adverse reactions are those usually noted with agonists-antagonists; psychotomimetic effects seem to occur less frequently than with pentazocine. Although the abuse potential of these newer agents has been determined to be less than that of codeine or propoxyphene hydrochloride, physicians should prescribe them with the same cautions used for narcotics to prevent their possible abuse. (JAMA 243:1465-1467, 1980)

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