BNF for Children 2011-2012

636 15.1.3 Antimuscarinic drugs BNFC 2011–201215 AnaesthesiaControl of muscarinic side-effects of edrophoniumin reversal of competitive neuromuscularblock. By intravenous injectionChild 1 month–18 years 7 micrograms/kg (max.600 micrograms)Cycloplegia, anterior uveitis (section 11.5)Administration for administration by mouth, injectionsolution may be given orally1Atropine (Non-proprietary) AInjection, atropine sulphate 600 micrograms/mL, netprice 1-mL amp = 62pNote Other strengths also availableInjection, prefilled disposable syringe, atropine sulphate100 micrograms/mL, net price 5 mL = £4.58,10 mL = £5.39, 30 mL = £8.95Injection, prefilled disposable syringe, atropine sulphate200 micrograms/mL, net price 5 mL = £5.91;300 micrograms/mL, 10 mL = £5.91; 600 micrograms/mL,1 mL = £5.91Oral solution, atropine sulphate 100 micrograms/mLavailable from ‘special-order’ manufacturers or specialistimporting companies, see p. 809TabletsU, atropine sulphate 600 micrograms, netprice 28-tab pack = £17.591. A restriction does not apply where administration is forsaving life in emergency1Minijet c Atropine (UCB Pharma) AInjection, atropine sulphate 100 micrograms/mL, netprice 5 mL = £5.04, 10 mL = £5.93, 30 mL = £9.851. A restriction does not apply where administration is forsaving life in emergencyGLYCOPYRRONIUM BROMIDE(Glycopyrrolate)Cautions section 1.2Contra-indications section 1.2Side-effects section 1.2Licensed use not licensed for use in control of upperairways secretion and hypersalivationIndication and dosePremedication at induction. By intravenous or intramuscular injectionNeonate 5 micrograms/kgChild 1 month–12 years 4–8 micrograms/kg(max. 200 micrograms)Child 12–18 years 200–400 micrograms or 4–5 micrograms/kg (max. 400 micrograms)Intra-operative bradycardia. By intravenous injectionNeonate 10 micrograms/kg, repeated if necessaryChild 1 month–18 years 4–8 micrograms/kg(max. 200 micrograms), repeated if necessaryControl of muscarinic side-effects of neostigminein reversal of competitive neuromuscularblock. By intravenous injectionNeonate 10 micrograms/kgChild 1 month–12 years 10 micrograms/kg(max. 500 micrograms)Child 12–18 years 200 micrograms per 1 mg ofneostigmine, or 10–15 micrograms/kgControl of upper airways secretion and hypersalivation. By mouthChild 1 month–18 years 40–100 micrograms/kg(max. 2 mg) 3–4 times daily, adjusted according toresponse. By subcutaneous infusionChild 1 month–12 years 12–40 micrograms/kg/24 hours (max. 1.2 mg)Child 12–18 years 0.6–1.2 mg/24 hours. By subcutaneous injection or intramuscularinjection or intravenous injection (but seenotes above)Child 1 month–12 years 4–10 micrograms/kg(max. 200 micrograms) 4 times a day whenrequiredChild 12–18 years 200 micrograms every 4 hourswhen requiredAdministration for administration by mouth, injectionsolution may be given or crushed tablets suspended inwaterGlycopyrronium bromide (Non-proprietary)Injection, glycopyrronium bromide 200 micrograms/mL, net price 1-mL amp = 54p, 3-mL amp = 91pTablets, glycopyrronium bromide 1 mg and 2 mgAvailable on a named-patient basis from specialist importingcompanies, p. 809With neostigmine metilsulphateSection 15.1.6HYOSCINE HYDROBROMIDE(Scopolamine hydrobromide)Cautions see notes in section 1.2 and notes above;also epilepsyContra-indications see notes in section 1.2Hepatic impairment see Hyoscine Hydrobromide,section 4.6Renal impairment see Hyoscine Hydrobromide, section4.6Pregnancy see Hyoscine Hydrobromide, section 4.6Breast-feeding see Hyoscine Hydrobromide, section4.6Side-effects see notes in section 1.2Indication and dosePremedication. By subcutaneous or intramuscular injection30–60 minutes before inductionChild 1–12 years 15 micrograms/kg (max.600 micrograms)Child 12–18 years 200–600 microgramsNote Same dose may be given by intravenous injectionimmediately before induction