BNF for Children 2011-2012

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548 12.3.5 Treatment of dry mouth BNFC 2011–201212 Ear, nose, and oropharynxSODIUM CHLORIDEIndication and doseOral hygiene (see notes above); for dose, see underpreparationSodium Chloride Mouthwash, Compound, BPMouthwash, sodium bicarbonate 1%, sodium chloride1.5% in a suitable vehicle with a peppermintflavourDoseExtemporaneous preparations should be preparedaccording to the following formula: sodium chloride 1.5 g,sodium bicarbonate 1 g, concentrated peppermint emulsion2.5 mL, double-strength chloroform water 50 mL,water to 100 mLTo be diluted with an equal volume of warm waterDental prescribing on NHS Compound Sodium ChlorideMouthwash may be prescribedTHYMOLIndication and doseOral hygiene (see notes above); for dose, see underpreparationMouthwash Solution-tabletsConsist of tablets which may contain antimicrobial,colouring, and flavouring agents in a suitable solubleeffervescent basis to make a mouthwash suitable fordental purposes. Net price 100-tab pack = £15.09DoseDissolve 1 tablet in a tumblerful of warm waterNote Mouthwash Solution-tablets may contain ingredientssuch as thymolDental prescribing on NHS Mouthwash Solution-tabletsmay be prescribed12.3.5 Treatment of dry mouthDry mouth (xerostomia) may be caused by drugs withantimuscarinic (anticholinergic) side-effects (e.g. antispasmodicsand sedating antihistamines), by irradiationof the head and neck region or by damage to or diseaseof the salivary glands. Children with a persistently drymouth may develop a burning or scalded sensation andhave poor oral hygiene; they may develop dental caries,periodontal disease, and oral infections (particularlycandidiasis). Dry mouth may be relieved in manypatients by simple measures such as frequent sips ofcool drinks or sucking pieces of ice or sugar-free fruitpastilles. Sugar-free chewing gum stimulates salivationin patients with residual salivary function.Artificial saliva can provide useful relief of dry mouth.A properly balanced artificial saliva should be of aneutral pH and contain electrolytes (including fluoride)to correspond approximately to the composition ofsaliva. The acidic pH of some artificial saliva productsmay be inappropriate.Local treatmentArtificial saliva products with ACBS approval may beprescribed for children with dry mouth as a result ofhaving (or having undergone) radiotherapy, or siccasyndrome. SST tablets may also be prescribed on theNHS.AS Saliva Orthana c (AS Pharma)Oral spray, gastric mucin (porcine) 3.5%, xylitol 2%,sodium fluoride 4.2 mg/litre, with preservatives andflavouring agents, pH neutral, net price 50-mL bottle= £4.92; 500-mL refill = £34.27Dose(ACBS) spray 2–3 times onto oral and pharyngealmucosa, when requiredDental prescribing on NHS AS Saliva Orthana c Oral Spraymay be prescribedLozenges, mucin 65 mg, xylitol 59 mg, in a sorbitolbasis, pH neutral, net price 30-lozenge pack = £3.50Note AS Saliva Orthana c lozenges do not contain fluorideDental prescribing on NHS AS Saliva Orthana c Lozengesmay be prescribedBiotène Oralbalance c (GSK)Saliva replacement gel, lactoperoxidase, lactoferrin,lysozyme, glucose oxidase, xylitol in a gel basis, netprice 50-g tube = £4.10; 24 12.4 mL tube = £30.40(for hospital use)DoseSymptomatic treatment of dry mouthApply to gums and tongue as requiredNote Avoid use with toothpastes containing detergents(including foaming agents)Dental prescribing on NHS Biotène Oralbalance c SalivaReplacement Gel may be prescribedBioXtra c (RIS Products)Gel, lactoperoxidase, lactoferrin, lysozyme, wheycolostrum, xylitol and other ingredients, net price 40-mL tube = £3.94, 50-mL spray = £3.94Dose(ACBS) apply to oral mucosa as requiredDental prescribing on NHS BioXtra c Gel may beprescribedGlandosane c (Fresenius Kabi)Aerosol spray, carmellose sodium 500 mg, sorbitol1.5 g, potassium chloride 60 mg, sodium chloride42.2 mg, magnesium chloride 2.6 mg, calcium chloride7.3 mg, and dipotassium hydrogen phosphate17.1 mg/50 g, pH 5.75, net price 50-mL unit (neutral,lemon or peppermint flavoured) = £4.82Dose(ACBS) spray onto oral and pharyngeal mucosa asrequiredDental prescribing on NHS Glandosane c Aerosol Spraymay be prescribedSaliveze c (Wyvern)Oral spray, carmellose sodium (sodium carboxymethylcellulose),calcium chloride, magnesiumchloride, potassium chloride, sodium chloride, anddibasic sodium phosphate, pH neutral, net price 50-mL bottle (mint-flavoured) = £3.50Dose(ACBS) 1 spray onto oral mucosa as requiredDental prescribing on NHS Saliveze c Oral Spray may beprescribed
BNFC 2011–2012 12.3.5 Treatment of dry mouth 549Salivix c (Galen)Pastilles, sugar-free, reddish-amber, acacia, malicacid and other ingredients. Net price 50-pastille pack= £3.50Dose(ACBS) suck 1 pastille when requiredDental prescribing on NHS Salivix c Pastilles may beprescribedSST (Medac)Tablets, sugar-free, citric acid, malic acid and otheringredients in a sorbitol base, net price 100-tab pack =£4.86DoseSymptomatic treatment of dry mouth in patients withimpaired salivary gland function and patent salivaryductsAllow 1 tablet to dissolve slowly in the mouth whenrequiredDental prescribing on NHS May be prescribed as SalivaStimulating TabletsXerotin c (SpePharm)Oral spray, sugar-free, water, sorbitol, carmellose(carboxymethylcellulose), potassium chloride, sodiumchloride, potassium phosphate, magnesium chloride,calcium chloride and other ingredients, pH neutral.Net price 100-mL unit = £6.86DoseSymptomatic treatment of dry mouthSpray as requiredDental prescribing on NHS Xerotin c Oral Spray may beprescribed as Artificial Saliva Oral Spray12 Ear, nose, and oropharynx
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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 3.3 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 5.1.11 Metronidazole
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BNFC 2011-2012 5.1.12 Quinolones 29
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BNFC 2011-2012 5.1.13 Urinary-tract
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BNFC 2011-2012 5.2.1 Triazole antif
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BNFC 2011-2012 5.2.1 Triazole antif
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BNFC 2011-2012 5.2.2 Imidazole anti
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BNFC 2011-2012 5.2.4 Echinocandin a
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BNFC 2011-2012 5.3 Antiviral drugs
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BNFC 2011-2012 5.3.1 HIV infection
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BNFC 2011-2012 5.3.2 Herpesvirus in
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BNFC 2011-2012 5.3.2 Herpesvirus in
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BNFC 2011-2012 5.3.3 Viral hepatiti
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BNFC 2011-2012 5.3.5 Respiratory sy
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BNFC 2011-2012 5.4 Antiprotozoal dr
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BNFC 2011-2012 5.4.1 Antimalarials
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BNFC 2011-2012 5.4.2 Amoebicides 33
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BNFC 2011-2012 5.4.6 Trypanocides 3
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BNFC 2011-2012 5.4.8 Drugs for pneu
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BNFC 2011-2012 5.5.2 Ascaricides 34
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BNFC 2011-2012 5.5.8 Drugs for stro
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BNFC 2011-2012 6.1.1 Insulins 349Tr
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BNFC 2011-2012 6.1.1 Insulins 351So
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BNFC 2011-2012 6.1.1 Insulins 353IN
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BNFC 2011-2012 6.1.1 Insulins 355Hi
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BNFC 2011-2012 6.1.2 Antidiabetic d
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BNFC 2011-2012 6.1.2 Antidiabetic d
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BNFC 2011-2012 6.1.4 Treatment of h
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BNFC 2011-2012 6.1.6 Diagnostic and
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BNFC 2011-2012 6.2 Thyroid and anti
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BNFC 2011-2012 6.2.2 Antithyroid dr
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BNFC 2011-2012 6.3.2 Glucocorticoid
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BNFC 2011-2012 6.4 Sex hormones 377
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BNFC 2011-2012 6.4.2 Male sex hormo
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BNFC 2011-2012 6.4.3 Anabolic stero
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BNFC 2011-2012 6.5.1 Hypothalamic a
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BNFC 2011-2012 6.5.2 Posterior pitu
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BNFC 2011-2012 6.5.2 Posterior pitu
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BNFC 2011-2012 6.6.2 Bisphosphonate
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BNFC 2011-2012 6.7.3 Metyrapone 391
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BNFC 2011-2012 3937 Obstetrics, gyn
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BNFC 2011-2012 7.2.2 Vaginal and vu
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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 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 9.2.1 Oral preparati
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BNFC 2011-2012 9.2.2 Parenteral pre
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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 9.6.5 Vitamin E 4851
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BNFC 2011-2012 9.6.7 Multivitamin p
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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 15.1.7 Antagonists f
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BNFC 2011-2012 15.2 Local anaesthes
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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
Page 795 and 796:
Medium-chainTriglyceride (MCT)Oil(S
Page 797 and 798:
Calshake c(Fresenius Kabi)Powderper
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BNFC 2011-2012 A2.5 Feed additives
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BNFC 2011-2012 A2.6.1 Gluten-free f
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BNFC 2011-2012 A2.7 Nutritional sup
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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
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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
Page 863 and 864:
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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