BNF for Children 2011-2012

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598 13.13 Topical circulatory preparations BNFC 2011–2012Hirudoid c (Genus) UCream, heparinoid 0.3% in a vanishing-cream basis,net price 50 g = £3.99Excipients include cetostearyl alcohol, hydroxybenzoates (parabens)DoseSuperficial thrombophlebitis, bruising, and haematomaChild 5–18 years apply up to 4 times dailyGel, heparinoid 0.3%, net price 50 g = £3.99Excipients include propylene glycol, fragranceDoseSuperficial thrombophlebitis, bruising, and haematomaChild 5–18 years apply up to 4 times daily13 Skin
BNFC 2011–2012 59914 Immunological productsand vaccines14.1 Active immunity 59914.2 Passive immunity 60214.3 Storage and use 60214.4 Vaccines and antisera 60214.5 Immunoglobulins 62214.5.1 Normal Immunoglobulin 62214.5.2 Disease-specific immunoglobulins62414.5.3 Anti-D (Rh 0 ) immunoglobulin 62614.6 International travel 62614.1 Active immunityActive immunity can be acquired by natural disease orby vaccination. Vaccines stimulate production of antibodiesand other components of the immune mechanism;they consist of either:1. a live attenuated form of a virus (e.g. measles,mumps, and rubella vaccine) or bacteria (e.g. BCGvaccine), or2. inactivated preparations of a virus (e.g. influenzavaccine) or bacteria, or3. detoxified exotoxins produced by a micro-organism(e.g. tetanus vaccine), or4. extracts of a micro-organism, which may be derivedfrom the organism (e.g. pneumococcal vaccine) orproduced by recombinant DNA technology (e.g.hepatitis B vaccine).Live attenuated vaccines usually produce durableimmunity but not always as long-lasting as that resultingfrom natural infection.Inactivated vaccines may require a primary series ofinjections of vaccine to produce an adequate antibodyresponse, and in most cases booster (reinforcing) injectionsare required; the duration of immunity varies frommonths to many years. Some inactivated vaccines areadsorbed onto an adjuvant (such as aluminium hydroxide)to enhance the antibody response.Advice in this chapter reflects that in the handbookImmunisation against Infectious Disease (2006),which in turn reflects the guidance of the JointCommittee on Vaccination and Immunisation(JCVI).Chapters from the handbook are available atwww.dh.gov.uk/immunisationThe advice in this chapter also incorporates changesannounced by the Chief Medical Officer and HealthDepartment Updates.Cautions Most children can safely receive the majorityof vaccines. Vaccination may be postponed if the child issuffering from an acute illness; however, it is not necessaryto postpone immunisation in children with minorillnesses without fever or systemic upset. See also Predispositionto Neurological Problems, below. For individualswith bleeding disorders, see Route of Administration,below. If alcohol or disinfectant is used forcleansing the skin it should be allowed to evaporatebefore vaccination to prevent possible inactivation oflive vaccines.When 2 or more vaccines are required (and are notavailable as a combined preparation), they should begiven simultaneously at different sites, preferably in adifferent limb; if more than one injection is to be given inthe same limb, they should be administered at least2.5 cm apart (but see also BCG Vaccines, p. 603).When 2 live vaccines cannot be given at the sametime, they should be separated by an interval of atleast 4 weeks. For interactions see Appendix I (vaccines).See also Cautions under individual vaccines.Contra-indications Vaccines are contra-indicated inchildren who have a confirmed anaphylactic reaction toa preceding dose of a vaccine containing the sameantigens or vaccine component (such as antibacterialsin viral vaccines). The presence of the following excipientsin vaccines and immunological products has beennoted under the relevant entries:GelatinGentamicinKanamycinNeomycinPenicillinsPolymyxin BStreptomycinThiomersalHypersensitivity to egg with evidence of previous anaphylacticreaction, contra-indicates influenza vaccine(prepared in hens’ eggs), tick-borne encephalitisvaccine, and yellow fever vaccine. See also Cautionsunder MMR vaccine.See also Vaccines and HIV infection, below.Live vaccines may be contra-indicated temporarily inchildren who are:. immunosuppressed (see Impaired ImmuneResponse, below);. pregnant (see Pregnancy and Breast-feeding,below).See also Contra-indications under individual vaccines.Impaired immune response Immune response to vaccinesmay be reduced in immunosuppressed childrenand there is also a risk of generalised infection with livevaccines. Severely immunosuppressed children shouldnot be given live vaccines (including those with severeprimary immunodeficiency). Specialist advice should besought for children being treated with high doses ofcorticosteroids (dose equivalents of prednisolone: children,2 mg/kg (or more than 40 mg) daily for at least 1week or 1 mg/kg daily for 1 month), or other immuno-14 Immunological products and vaccines
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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 5.1.2 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 9.1.1 Iron-deficienc
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BNFC 2011-2012 9.2.1 Oral preparati
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BNFC 2011-2012 9.2.2 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 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 11.3.1 Antibacterial
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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 11.9 Contact lenses
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BNFC 2011-2012 12.3 Drugs acting on
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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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Nutrison c(Nutricia Clinical)Nutris
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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
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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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BNFC 2011-2012 Appendix 3: Cautiona
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BNFC 2011-2012 Dental Practitioners
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BNFC 2011-2012 Nurse Prescribers’
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BNFC 2011-2012 799Non-medical presc
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BNFC 2011-2012 Index of manufacture
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BNFC 2011-2012 809Special-orderManu
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BNFC 2011-2012 Abacavir—Alfacalci
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BNFC 2011-2012 Anthelios—Arthrofe
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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
show all

BNF for Children 2011-2012

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