BNF for Children 2011-2012

442 BNFC 2011–20129 Nutrition and blood9 Nutrition and blood9.1 Anaemias and some other blooddisorders 4429.1.1 Iron-deficiency anaemias 4429.1.1.1 Oral iron 4429.1.1.2 Parenteral iron 4449.1.2 Drugs used in megaloblasticanaemias 4459.1.3 Drugs used in hypoplastic,haemolytic, and renal anaemias 4479.1.4 Drugs used in platelet disorders 4539.1.5 G6PD deficiency 4549.1.6 Drugs used in neutropenia 4549.2 Fluids and electrolytes 4569.2.1 Oral preparations for fluid andelectrolyte imbalance 4579.2.1.1 Oral potassium 4579.2.1.2 Oral sodium and water 4589.2.1.3 Oral bicarbonate 4609.2.2 Parenteral preparations for fluidand electrolyte imbalance 4609.2.2.1 Electrolytes and water 4609.2.2.2 Plasma and plasma substitutes 4649.3 Intravenous nutrition 4669.4 Oral nutrition 4689.4.1 Foods for special diets 4689.4.2 Enteral nutrition 4699.5 Minerals 4719.5.1 Calcium and magnesium 4719.5.1.1 Calcium supplements 4719.5.1.2 Hypercalcaemia and hypercalciuria4739.5.1.3 Magnesium 4739.5.2 Phosphorus 4749.5.2.1 Phosphate supplements 4749.5.2.2 Phosphate-binding agents 4759.5.3 Fluoride 4769.5.4 Zinc 4789.6 Vitamins 4789.6.1 Vitamin A 4789.6.2 Vitamin B group 4799.6.3 Vitamin C 4819.6.4 Vitamin D 4829.6.5 Vitamin E 4859.6.6 Vitamin K 4869.6.7 Multivitamin preparations 4879.7 Bitters and tonics 4889.8 Metabolic disorders 4889.8.1 Drugs used in metabolic disorders4889.8.2 Acute porphyrias 4979.1 Anaemias and some otherblood disorders9.1.1 Iron-deficiency anaemias9.1.2 Drugs used in megaloblastic anaemias9.1.3 Drugs used in hypoplastic,haemolytic, and renal anaemias9.1.4 Drugs used in platelet disorders9.1.5 G6PD deficiency9.1.6 Drugs used in neutropeniaBefore initiating treatment for anaemia it is essential todetermine which type is present. Iron salts may beharmful and result in iron overload if given alone topatients with anaemias other than those due to irondeficiency.9.1.1 Iron-deficiency anaemias9.1.1.1 Oral iron9.1.1.2 Parenteral ironTreatment with an iron preparation is justified only inthe presence of a demonstrable iron-deficiency state.Before starting treatment, it is important to exclude anyserious underlying cause of the anaemia (e.g. gastrointestinalbleeding). The possibility of thalassaemiashould be considered in children of Mediterranean orIndian subcontinent descent.Prophylaxis with an iron preparation may be appropriatein those with a poor diet, malabsorption, menorrhagia,pregnancy, in haemodialysis patients, and in themanagement of low birth-weight infants such as pretermneonates.9.1.1.1 Oral ironIron salts should be given by mouth unless there aregood reasons for using another route.Ferrous salts show only marginal differences betweenone another in efficiency of absorption of iron. Haemoglobinregeneration rate is little affected by the type ofsalt used provided sufficient iron is given, and in mostpatients the speed of response is not critical. Choice ofpreparation is thus usually decided by formulation,palatability, incidence of side-effects, and cost.