BNF for Children 2011-2012

46 1.4 Acute diarrhoea BNFC 2011–20121 Gastro-intestinal systemAdministration for administration by a nasogastrictube or an oral syringe, Zoton FasTab c can bedispersed in a small amount of waterZoton c (Wyeth) AFasTab c (= orodispersible tablet), lansoprazole15 mg, net price 28-tab pack = £2.99; 30 mg, 28-tabpack = £5.50. Label: 5, 22, counselling, administrationExcipients include aspartame (section 9.4.1)Counselling Tablets should be placed on the tongue,allowed to disperse and swallowed, or may be swallowedwhole with a glass of water.OMEPRAZOLECautions interactions: Appendix 1 (proton pumpinhibitors)Hepatic impairment no more than 700 micrograms/kg (max. 20 mg) once dailyPregnancy not known to be harmfulBreast-feeding present in milk but not known to beharmfulSide-effects see notes above; also agitation andimpotenceLicensed use capsules and tablets not licensed foruse in children except for severe ulcerating refluxoesophagitis in children over 1 year; injection notlicensed for use in children under 12 yearsIndication and doseGastro-oesophageal reflux disease, acidrelateddyspepsia, treatment of duodenal andbenign gastric ulcers including those complicatingNSAID therapy, prophylaxis of acidaspiration, Zollinger-Ellison syndrome, fatmalabsorption despite pancreatic enzymereplacement therapy in cystic fibrosis. By mouthNeonate 700 micrograms/kg once daily, increasedif necessary after 7–14 days to 1.4 mg/kg; someneonates may require up to 2.8 mg/kg once dailyChild 1 month–2 years 700 micrograms/kg oncedaily, increased if necessary to 3 mg/kg (max.20 mg) once dailyChild body-weight 10–20 kg 10 mg once dailyincreased if necessary to 20 mg once daily (insevere ulcerating reflux oesophagitis, max. 12weeks at higher dose)Child body-weight over 20 kg 20 mg once dailyincreased if necessary to 40 mg once daily (insevere ulcerating reflux oesophagitis, max. 12weeks at higher dose). By intravenous injection over 5 minutes or byintravenous infusionChild 1 month–12 years initially 500 micrograms/kg(max. 20 mg) once daily, increased to2 mg/kg (max. 40 mg) once daily if necessaryChild 12–18 years 40 mg once dailyHelicobacter pylori eradication (in combinationwith antibacterials see p. 42). By mouthChild 1–12 years 1–2 mg/kg (max. 40 mg) oncedailyChild 12–18 years 40 mg once dailyAdministration for administration by mouth, swallowwhole, or disperse Losec MUPS c tablets in water, ormix capsule contents or Losec MUPS c tablets withfruit juice or yoghurt. Preparations consisting of ane/c tablet within a capsule should not be opened.For administration through an enteral feeding tube,use Losec MUPS c or the contents of a capsulecontaining omeprazole dispersed in a large volume ofwater, or in 10 mL Sodium Bicarbonate 8.4% (1 mmolNa + /mL) (allow to stand for 10 minutes beforeadministration).For intermittent intravenous infusion, dilute reconstitutedsolution to a concentration of 400 micrograms/mL with Glucose 5% or Sodium Chloride 0.9%; giveover 20–30 minutesOmeprazole (Non-proprietary) ACapsules, enclosing e/c granules, omeprazole 10 mg,net price 28-cap pack = £1.81; 20 mg, 28-cap pack =£1.92; 40 mg, 7-cap pack = £1.95, 28-cap pack =£21.65. Counselling, administrationNote Some preparations consist of an e/c tablet within acapsuleBrands include Mepradec cDental prescribing on NHS Gastro-resistant omeprazolecapsules may be prescribedTablets, e/c, omeprazole 10 mg, net price 28-tab pack= £5.84; 20 mg, 28-tab pack = £5.71; 40 mg, 7-tab pack= £5.15. Label: 25Intravenous infusion, powder for reconstitution,omeprazole (as sodium salt), net price 40-mg vial =£5.18Losec c (AstraZeneca) AMUPS c (multiple-unit pellet system = dispersibletablets), f/c, omeprazole 10 mg (light pink), net price28-tab pack = £7.75; 20 mg (pink), 28-tab pack =£11.60; 40 mg (red-brown), 7-tab pack = £5.80.Counselling, administrationCapsules, enclosing e/c granules, omeprazole 10 mg(pink), net price 28-cap pack = £7.75; 20 mg (pink/brown), 28-cap pack = £11.60; 40 mg (brown), 7-cappack = £5.80. Counselling, administrationIntravenous infusion, powder for reconstitution,omeprazole (as sodium salt), net price 40-mg vial =£5.41Injection, powder for reconstitution, omeprazole (assodium salt), net price 40-mg vial (with solvent) =£5.411.4 Acute diarrhoea1.4.1 Adsorbents and bulk-forming drugs1.4.2 Antimotility drugsThe priority in acute diarrhoea, as in gastro-enteritis, isthe prevention or reversal of fluid and electrolyte depletion—thisis particularly important in infants. For detailsof oral rehydration preparations, see section 9.2.1.2.Severe dehydration requires immediate admission tohospital and urgent replacement of fluid and electrolytes.Antimotility drugs (section 1.4.2) relieve symptoms ofdiarrhoea. They are used in the management of uncomplicatedacute diarrhoea in adults, but are not recom-