BNF for Children 2011-2012

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346 5.5.4 Drugs for hookworms BNFC 2011–2012gastro-intestinal upset, lightheadedness, and pruritus; itis not effective against larval worms. Fears of developingcysticercosis in Taenia solium infections haveproved unfounded. All the same, an antiemetic can begiven before treatment and a laxative can be given 2hours after niclosamide.Praziquantel [unlicensed] is available from Merck Serono(Cysticide c ); it is as effective as niclosamide and isgiven to children over 4 years of age as a single dose of5–10 mg/kg after a light breakfast (or as a single dose of25 mg/kg for Hymenolepis nana).Praziquantel [unlicensed] is available from Merck Serono(Cysticide c ) and is effective against all humanschistosomes. In children over 4 years the dose is20 mg/kg followed after 4–6 hours by a further dose of20 mg/kg (20 mg/kg 3 times daily for one day for S.japonicum infections). No serious adverse effects havebeen reported. Of all the available schistosomicides, ithas the most attractive combination of effectiveness,broad-spectrum activity, and low toxicity.5 InfectionsHydatid diseaseCysts caused by Echinococcus granulosus grow slowlyand asymptomatic children do not always require treatment.Surgical treatment remains the method of choicein many situations. Albendazole [unlicensed] (availablefrom ‘special-order’ manufacturers or specialist importingcompanies, see p. 809 is used in conjunction withsurgery to reduce the risk of recurrence or as primarytreatment in inoperable cases. Albendazole is given tochildren over 2 years of age in a dose of 7.5 mg/kg twicedaily (max. 400 mg twice daily) for 28 days followed by14-day break and then repeated for up to 2–3 cycles.Alveolar echinococcosis due to E. multilocularis isusually fatal if untreated. Surgical removal with albendazolecover is the treatment of choice, but where effectivesurgery is impossible, repeated cycles of albendazole(for a year or more) may help. Careful monitoringof liver function is particularly important during drugtreatment.5.5.4 Drugs for hookworms(ancylostomiasis, necatoriasis)Hookworms live in the upper small intestine and drawblood from the point of their attachment to their host.An iron-deficiency anaemia may occur and, if present,effective treatment of the infection requires not onlyexpulsion of the worms but treatment of the anaemia.Mebendazole (section 5.5.1) has a useful broad-spectrumactivity, and is effective against hookworms.Albendazole [unlicensed] (available from ‘specialorder’manufacturers or specialist importing companies,see p. 809) given as a single dose of 400 mg in childrenover 2 years, is an alternative. Levamisole is alsoeffective (section 5.5.2).5.5.5 Schistosomicides(bilharziasis)Adult Schistosoma haematobium worms live in thegenito-urinary veins and adult S. mansoni in those ofthe colon and mesentery. S. japonicum is more widelydistributed in veins of the alimentary tract and portalsystem.5.5.6 FilaricidesDiethylcarbamazine [unlicensed] (available from ‘special-order’manufacturers or specialist importing companies,see p. 809) is effective against microfilariae andadult worms of Loa loa, Wuchereria bancrofti, andBrugia malayi. To minimise reactions, treatment inchildren over 1 month is commenced with a dose ofdiethylcarbamazine citrate 1 mg/kg in divided doses onthe first day and increased gradually over 3 days to6 mg/kg daily (3 mg/kg daily if child under 10 years) individed doses; length of treatment varies according toinfection type, and usually gives a radical cure for theseinfections. Close medical supervision is necessary particularlyin the early phase of treatment. In heavy infectionsthere may be a febrile reaction, and in heavy Loaloa infection there is a small risk of encephalopathy. Insuch cases specialist advice should be sought, andtreatment must be given under careful in-patient supervisionand stopped at the first sign of cerebral involvement.Ivermectin [unlicensed] (available from ‘special-order’manufacturers or specialist importing companies, seep. 809) is very effective in onchocerciasis and it is nowthe drug of choice. In children over 5 years, a singledose of 150 micrograms/kg by mouth produces a prolongedreduction in microfilarial levels. Retreatment atintervals of 6 to 12 months depending on symptomsmust be given until the adult worms die out. Reactionsare usually slight and most commonly take the form oftemporary aggravation of itching and rash. Diethylcarbamazineor suramin should no longer be used foronchocerciasis because of their toxicity.5.5.7 Drugs for cutaneous larvamigrans(creeping eruption)Dog and cat hookworm larvae may enter human skinwhere they produce slowly extending itching tracksusually on the foot. Single tracks can be treated withtopical tiabendazole (no commercial preparation available).Multiple infections respond to ivermectin,albendazole or tiabendazole (thiabendazole) bymouth (all unlicensed and available from ‘specialorder’manufacturers or specialist importing companies,see p. 809).
BNFC 2011–2012 5.5.8 Drugs for strongyloidiasis 3475.5.8 Drugs for strongyloidiasisAdult forms of Strongyloides stercoralis live in the gutand produce larvae which penetrate the gut wall andinvade the tissues, setting up a cycle of auto-infection.Ivermectin [unlicensed] in a dose of 200 micrograms/kg daily for 2 days is the treatment of choice for chronicStrongyloides infection in children over 5 years.Albendazole [unlicensed] is an alternative in childrenover 2 years given in a dose of 400 mg twice daily for 3days, repeated after 3 weeks if necessary.Both of these drugs are available from ‘special-order’manufacturers or specialist importing companies, seep. 809.5 Infections
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Medicines information servicesInfor
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Published byBMJ GroupTavistock Squa
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iv BNFC 2011-2012PrefaceBNF for Chi
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vi BNFC 2011-2012BNF StaffDigital D
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viii BNFC 2011-2012Nurse Prescriber
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x BNFC 2011-2012. incorporating the
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xii BNFC 2011-2012prescribing notes
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Branded oral liquid preparations th
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xvi BNFC 2011-2012Finding significa
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xviii BNFC 2011-2012Epilim Chronosp
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xx BNFC 2011-2012Tears Naturale c S
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2 General guidance BNFC 2011-2012Ge
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4 Prescription writing BNFC 2011-20
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6 Supply of medicines BNFC 2011-201
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8 Emergency supply of medicines BNF
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10 Prescribing Controlled Drugs BNF
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Adverse reactions to drugs12 Advers
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Prescribing in hepatic impairment14
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Prescribing in pregnancy16 Prescrib
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18 Prescribing in palliative care B
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20 Prescribing in palliative care B
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22 Prescribing in dental practice B
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Emergency treatment of poisoning24
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26 Emergency treatment of poisoning
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36 1.1.1 Antacids and simeticone BN
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38 1.1.2 Compound alginate preparat
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40 1.2 Antispasmodics and other dru
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42 1.3 Antisecretory drugs and muco
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44 1.3.3 Chelates and complexes BNF
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46 1.4 Acute diarrhoea BNFC 2011-20
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48 1.5 Chronic bowel disorders BNFC
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50 1.5.1 Aminosalicylates BNFC 2011
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52 1.5.1 Aminosalicylates BNFC 2011
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54 1.5.3 Drugs affecting the immune
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56 1.5.4 Food allergy BNFC 2011-201
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58 1.6.1 Bulk-forming laxatives BNF
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60 1.6.2 Stimulant laxatives BNFC 2
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62 1.6.4 Osmotic laxatives BNFC 201
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64 1.6.5 Bowel cleansing preparatio
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66 1.7 Local preparations for anal
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68 1.8 Stoma and enteral feeding tu
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70 1.9.2 Bile acid sequestrants BNF
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72 1.9.4 Pancreatin BNFC 2011-20121
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74 2.1.1 Cardiac glycosides BNFC 20
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76 2.2 Diuretics BNFC 2011-20122 Ca
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78 2.2.2 Loop diuretics BNFC 2011-2
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BNFC 2011-2012 2.2.4 Potassium-spar
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BNFC 2011-2012 2.3.2 Drugs for arrh
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BNFC 2011-2012 2.3.2 Drugs for arrh
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BNFC 2011-2012 2.4 Beta-adrenocepto
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BNFC 2011-2012 2.5.1 Vasodilator an
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BNFC 2011-2012 2.5.4 Alpha-adrenoce
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BNFC 2011-2012 2.5.5 Drugs affectin
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BNFC 2011-2012 2.5.5 Drugs affectin
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BNFC 2011-2012 2.6.2 Calcium-channe
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BNFC 2011-2012 2.7.1 Inotropic symp
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BNFC 2011-2012 2.7.2 Vasoconstricto
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BNFC 2011-2012 2.8.1 Parenteral ant
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BNFC 2011-2012 2.8.1 Parenteral ant
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BNFC 2011-2012 2.8.2 Oral anticoagu
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BNFC 2011-2012 2.10 Myocardial infa
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BNFC 2011-2012 2.11 Antifibrinolyti
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BNFC 2011-2012 2.12 Lipid-regulatin
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BNFC 2011-2012 2.14 Drugs affecting
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BNFC 2011-2012 1333 Respiratory sys
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BNFC 2011-2012 3.1 Bronchodilators
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BNFC 2011-2012 3.1.1 Adrenoceptor a
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BNFC 2011-2012 3.1.1 Adrenoceptor a
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BNFC 2011-2012 3.1.2 Antimuscarinic
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BNFC 2011-2012 3.1.3 Theophylline 1
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BNFC 2011-2012 3.1.5 Peak flow mete
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BNFC 2011-2012 3.2 Corticosteroids
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BNFC 2011-2012 3.2 Corticosteroids
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BNFC 2011-2012 3.3 Cromoglicate and
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BNFC 2011-2012 3.4 Antihistamines,
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BNFC 2011-2012 3.4.1 Antihistamines
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BNFC 2011-2012 3.4.2 Allergen immun
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BNFC 2011-2012 3.4.3 Allergic emerg
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BNFC 2011-2012 3.4.3 Allergic emerg
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BNFC 2011-2012 3.6 Oxygen 163ment
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BNFC 2011-2012 3.7 Mucolytics 165HO
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BNFC 2011-2012 3.9 Cough preparatio
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BNFC 2011-2012 1694 Central nervous
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BNFC 2011-2012 4.1.2 Anxiolytics 17
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BNFC 2011-2012 4.2.1 Antipsychotic
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BNFC 2011-2012 4.3 Antidepressant d
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BNFC 2011-2012 4.3.1 Tricyclic anti
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BNFC 2011-2012 4.3.3 Selective sero
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BNFC 2011-2012 4.4 CNS stimulants a
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BNFC 2011-2012 4.5 Drugs used in th
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BNFC 2011-2012 4.6 Drugs used in na
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BNFC 2011-2012 4.7 Analgesics 199Sc
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BNFC 2011-2012 4.7.1 Non-opioid ana
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BNFC 2011-2012 4.7.2 Opioid analges
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BNFC 2011-2012 4.7.4 Antimigraine d
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BNFC 2011-2012 4.8 Antiepileptics 2
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BNFC 2011-2012 4.8.1 Control of the
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BNFC 2011-2012 4.8.2 Drugs used in
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BNFC 2011-2012 4.8.3 Febrile convul
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BNFC 2011-2012 4.9.2 Antimuscarinic
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BNFC 2011-2012 4.10.2 Nicotine depe
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BNFC 2011-2012 4.10.2 Nicotine depe
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BNFC 2011-2012 5.1 Antibacterial dr
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BNFC 2011-2012 5.1.1 Penicillins 25
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BNFC 2011-2012 5.1.2 Cephalosporins
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BNFC 2011-2012 5.1.3 Tetracyclines
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BNFC 2011-2012 5.1.4 Aminoglycoside
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BNFC 2011-2012 5.1.4 Aminoglycoside
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BNFC 2011-2012 5.1.5 Macrolides 281
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BNFC 2011-2012 5.1.6 Clindamycin 28
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BNFC 2011-2012 5.1.7 Some other ant
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BNFC 2011-2012 5.1.7 Some other ant
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BNFC 2011-2012 5.1.8 Sulfonamides a
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BNFC 2011-2012 5.1.9 Antituberculos
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BNFC 2011-2012 5.1.9 Antituberculos
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BNFC 2011-2012 7.3.1 Combined hormo
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BNFC 2011-2012 7.3.2 Progestogen-on
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BNFC 2011-2012 7.3.2 Progestogen-on
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BNFC 2011-2012 7.3.4 Contraceptive
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BNFC 2011-2012 7.4 Drugs for genito
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BNFC 2011-2012 7.4.2 Drugs for urin
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BNFC 2011-2012 7.4.5 Drugs for erec
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BNFC 2011-2012 8.1 Cytotoxic drugs
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BNFC 2011-2012 8.1 Cytotoxic drugs
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BNFC 2011-2012 8.1.1 Alkylating dru
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BNFC 2011-2012 8.1.2 Cytotoxic anti
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BNFC 2011-2012 8.1.3 Antimetabolite
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BNFC 2011-2012 8.1.3 Antimetabolite
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BNFC 2011-2012 8.1.5 Other antineop
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BNFC 2011-2012 8.1.5 Other antineop
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BNFC 2011-2012 8.2 Drugs affecting
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BNFC 2011-2012 8.2.2 Corticosteroid
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BNFC 2011-2012 8.2.4 Other immunomo
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BNFC 2011-2012 9.1.1 Iron-deficienc
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BNFC 2011-2012 9.2.1 Oral preparati
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BNFC 2011-2012 9.3 Intravenous nutr
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BNFC 2011-2012 9.4.2 Enteral nutrit
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BNFC 2011-2012 9.5 Minerals 471dren
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BNFC 2011-2012 9.5.1 Calcium and ma
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BNFC 2011-2012 9.5.2 Phosphorus 475
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BNFC 2011-2012 9.5.3 Fluoride 477Ch
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BNFC 2011-2012 9.6.2 Vitamin B grou
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BNFC 2011-2012 9.6.3 Vitamin C 481I
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BNFC 2011-2012 9.6.4 Vitamin D 483N
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BNFC 2011-2012 9.6.7 Multivitamin p
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BNFC 2011-2012 9.8.2 Acute porphyri
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BNFC 2011-2012 49910 Musculoskeleta
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BNFC 2011-2012 10.1.1 Non-steroidal
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BNFC 2011-2012 10.1.3 Drugs that su
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BNFC 2011-2012 10.1.4 Gout and cyto
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BNFC 2011-2012 10.2.2 Skeletal musc
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BNFC 2011-2012 51711 Eye11.1 Admini
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BNFC 2011-2012 11.3.1 Antibacterial
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BNFC 2011-2012 11.4.2 Other anti-in
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BNFC 2011-2012 11.6 Treatment of gl
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BNFC 2011-2012 11.6 Treatment of gl
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BNFC 2011-2012 11.7 Local anaesthet
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BNFC 2011-2012 11.8.1 Tear deficien
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BNFC 2011-2012 11.9 Contact lenses
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BNFC 2011-2012 12.1.1 Otitis extern
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BNFC 2011-2012 12.3.2 Oropharyngeal
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BNFC 2011-2012 13.1.1 Vehicles 551m
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BNFC 2011-2012 13.3 Topical antipru
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BNFC 2011-2012 13.6.1 Topical prepa
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BNFC 2011-2012 13.6.2 Oral preparat
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BNFC 2011-2012 13.7 Preparations fo
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BNFC 2011-2012 13.8.2 Camouflagers
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BNFC 2011-2012 13.10 Anti-infective
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BNFC 2011-2012 13.10.1 Antibacteria
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BNFC 2011-2012 13.10.2 Antifungal p
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BNFC 2011-2012 13.10.3 Antiviral pr
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BNFC 2011-2012 13.11.2 Chlorhexidin
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BNFC 2011-2012 13.12 Antiperspirant
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BNFC 2011-2012 59914 Immunological
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BNFC 2011-2012 14.1 Active immunity
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BNFC 2011-2012 14.4 Vaccines and an
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BNFC 2011-2012 14.5.1 Normal Immuno
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BNFC 2011-2012 14.5.2 Disease-speci
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BNFC 2011-2012 14.6 International t
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BNFC 2011-2012 15.1.1 Intravenous a
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BNFC 2011-2012 15.1.1 Intravenous a
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BNFC 2011-2012 15.1.2 Inhalational
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BNFC 2011-2012 15.1.3 Antimuscarini
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BNFC 2011-2012 15.1.4 Sedative and
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BNFC 2011-2012 15.1.5 Neuromuscular
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BNFC 2011-2012 15.1.5 Neuromuscular
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BNFC 2011-2012 655A1InteractionsTwo
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BNFC 2011-2012 Appendix 1: Interact
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BNFC 2011-2012 743A2Borderline subs
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Nutrison c(Nutricia Clinical)Nutris
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A2.1.2 Enteral feeds (non-disease s
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A2.1.2.2 Enteral feeds: Less than 1
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A2.1.3 Enteral feeds (non-disease s
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Infatrini c(Nutricia Clinical)Nutri
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Frebini c EnergyDrink(Fresenius Kab
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A2.2.1.2 Nutritional supplements: M
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Fortisip c Range(Nutricia Clinical)
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Forticreme cComplete(Nutricia Clini
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A2.3 Specialised formulasA2.3.1 Spe
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Nutramigen c Lipil 2(Mead Johnson)S
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Specialised formulas: Infant and ch
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KetoCal c(SHS)Standard dilution(20
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A2.4 Feed supplementsA2.4.1 High-en
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Medium-chainTriglyceride (MCT)Oil(S
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Calshake c(Fresenius Kabi)Powderper
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BNFC 2011-2012 A2.5 Feed additives
Page 801 and 802:
BNFC 2011-2012 A2.6.1 Gluten-free f
Page 803 and 804:
BNFC 2011-2012 A2.7 Nutritional sup
Page 805 and 806:
Page 807 and 808:
Page 809 and 810:
Page 811 and 812:
BNFC 2011-2012 Appendix 3: Cautiona
Page 813 and 814:
BNFC 2011-2012 791A4Intravenous inf
Page 815 and 816:
BNFC 2011-2012 Appendix 4: Intraven
Page 817 and 818:
BNFC 2011-2012 Dental Practitioners
Page 819 and 820:
BNFC 2011-2012 Nurse Prescribers’
Page 821 and 822:
BNFC 2011-2012 799Non-medical presc
Page 823 and 824:
BNFC 2011-2012 Index of manufacture
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Page 827 and 828:
Page 829 and 830:
Page 831 and 832:
BNFC 2011-2012 809Special-orderManu
Page 833 and 834:
BNFC 2011-2012 Abacavir—Alfacalci
Page 835 and 836:
BNFC 2011-2012 Anthelios—Arthrofe
Page 837 and 838:
BNFC 2011-2012 Benzodiazepines—Bu
Page 839 and 840:
BNFC 2011-2012 Cetrimide—Cocaine
Page 841 and 842:
BNFC 2011-2012 Coumarins—Dermatop
Page 843 and 844:
BNFC 2011-2012 Disinfectants—Emer
Page 845 and 846:
BNFC 2011-2012 Eye—Formaldehyde 8
Page 847 and 848:
BNFC 2011-2012 Glycogen—Homatropi
Page 849 and 850:
BNFC 2011-2012 Ibuprofen—Iodide 8
Page 851 and 852:
BNFC 2011-2012 Laxatives—Magnesiu
Page 853 and 854:
BNFC 2011-2012 Methylenedioxymetham
Page 855 and 856:
BNFC 2011-2012 Nicardipine—Oftaqu
Page 857 and 858:
BNFC 2011-2012 Paramax—Plaquenil
Page 859 and 860:
BNFC 2011-2012 Procarbazine—Regul
Page 861 and 862:
BNFC 2011-2012 Scottish—Sodium 83
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BNFC 2011-2012 Syringes—Tocophero
Page 865 and 866:
BNFC 2011-2012 Ursofalk—Waxsol 84
Page 869 and 870:
NEWBORN LIFE SUPPORTDry the babyRem
Page 871 and 872:
PAEDIATRIC ADVANCED LIFE SUPPORTUnr
Page 873 and 874:
BODY SURFACE AREA IN CHILDRENBody-w
Page 875 and 876:
Croup(section 3.1)Dexamethasone ora
Page 877 and 878:
Recommended wording of cautionaryan
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BNF for Children 2011-2012

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