BNF for Children 2011-2012

456 9.2 Fluids and electrolytes BNFC 2011–2012Nivestim c (Hospira) TAInjection, prefilled syringe, filgrastim, net price12 million-units (120 micrograms)/0.2 mL = £36.00;30 million-units (300 micrograms)/0.5 mL = £58.00;48 million-units (480 micrograms)/0.5 mL = £93.00Note Biosimilar medicine, p. 2Ratiograstim c (Ratiopharm UK) TAInjection, prefilled syringe, filgrastim, net price30 million-units (300 micrograms)/0.5 mL = £62.26;48 million-units (480 micrograms)/0.8 mL = £99.29Note Biosimilar medicine, p. 2Tevagrastim c (TEVA UK) TAInjection, prefilled syringe, filgrastim, net price30 million-units (300 micrograms)/0.5 mL = £62.25;48 million-units (480 micrograms)/0.8 mL = £99.29Note Biosimilar medicine, p. 2chemotherapy and continued until neutrophilcount in acceptable range; for timing of leucopheresisconsult product literatureAdministration for intravenous infusion, dilutereconstituted solution to a concentration of not lessthan 2 micrograms/mL (Granocyte-13) or 2.5 micrograms/mL(Granocyte-34) with Sodium Chloride0.9%Granocyte c (Chugai) AInjection, powder for reconstitution, lenograstim, netprice 13.4 million-unit (105-microgram) vial = £40.11;33.6 million-unit (263-microgram) vial = £62.54 (bothwith 1-mL prefilled syringe water for injections)Excipients include phenylalanine (section 9.4.1)Zarzio c (Sandoz) TAInjection, prefilled syringe, filgrastim, net price30 million-units (300 micrograms)/0.5 mL = £59.00;48 million-units (480 micrograms)/0.5 mL = £94.00Note Biosimilar medicine, p. 29 Nutrition and bloodLENOGRASTIM(Recombinant human granulocyte-colony stimulatingfactor, rHuG-CSF)Cautions see notes abovePregnancy see notes aboveBreast-feeding see notes aboveSide-effects see notes above; also splenic rupture andtoxic epidermal necrolysisLicensed use not licensed for use in children forcytotoxic-induced neutropenia, mobilisation ofperipheral blood progenitor cells (monotherapy oradjunctive therapy), or following peripheral stemcells transplantationIndication and doseFollowing peripheral stem cells or bone-marrowtransplantation. By intravenous infusion over 30 minutes or bysubcutaneous injectionChild 2–18 years 150 micrograms/m 2 dailystarted the day after transplantation, continueduntil neutrophil count stable in acceptable range(max. 28 days)Cytotoxic-induced neutropenia. By subcutaneous injectionChild 2–18 years 150 micrograms/m 2 dailystarted the day after completion of chemotherapy,continued until neutrophil count stable in acceptablerange (max. 28 days)Mobilisation of peripheral blood progenitorcells, used alone. By subcutaneous injectionChild 2–18 years 10 micrograms/kg daily for 4–6days (5–6 days in healthy donors)Mobilisation of peripheral blood progenitorcells following adjunctive myelosuppressivechemotherapy (to improve yield). By subcutaneous injectionChild 2–18 years 150 micrograms/m 2 daily,started 1–5 days after completion of9.2 Fluids and electrolytes9.2.1 Oral preparations for fluid andelectrolyte imbalance9.2.2 Parenteral preparations for fluid andelectrolyte imbalanceThe following tables give a selection of useful electrolytevalues:Electrolyte concentrations—intravenousfluidsMillimoles per litreIntravenous infusion Na + K + HCO 3 Cl Ca 2þNormal plasma values 142 4.5 26 103 2.5Sodium Chloride 0.9% 150 — — 150 —Compound Sodium 131 5 29 111 2Lactate (Hartmann’s)Sodium Chloride0.45% and Glucose5%75 — — 75 —Potassium Chloride0.15% and Glucose5%Potassium Chloride0.15% and SodiumChloride 0.9%Potassium Chloride0.3% and Glucose 5%Potassium Chloride0.3% and SodiumChloride 0.9%— 20 — 20 —150 20 — 170 —— 40 — 40 —150 40 — 190 —To correct metabolic acidosisSodium Bicarbonate1.26%150 — 150 — —Sodium Bicarbonate 1000 — 1000 — —8.4% for cardiac arrestSodium Lactate (m/6) 167 — 167 — —