BNF for Children 2014 - 2015 (British National Formulary for by Pharmaceutical Press

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Subcutaneous infusion of diamorphine via a continuous infusion device can be useful (for details, see Continuous Subcutaneous Infusions), (p. 19). If the child can resume taking medicines by mouth, then oral morphine may be substituted for subcutaneous infusion of diamorphine. See table of Approximate Equivalent doses of Morphine and Diamorphine, (p. 20). Rectal route Morphine is also available for rectal administration as suppositories. 2; fentanyl patches should not be used in opioid naive children.

1 Prescribing Controlled Drugs 9 For a sample prescription, see below. 2 Prescriptions ordering ‘repeats’on the same form are not permitted for Controlled Drugs in Schedules 2 or 3. Private prescriptions Private prescriptions for Controlled Drugs in Schedules 2 and 3 must be written on specially designated forms provided by Primary Care Trusts in England, Health Boards in Scotland, Local Health Boards in Wales or the Northern Ireland Central Services Agency; in addition, prescriptions must specify the prescriber’s identification number.

Phenobarbital by mouth or as a continuous subcutaneous infusion may be beneficial; continuous infusion of midazolam is an alternative. Both cause drowsiness, but this is rarely a concern in the context of intractable seizures. For breakthrough convulsions diazepam (p. 236) given rectally (as a solution), buccal midazolam (p. 238), or paraldehyde (p. 238) as an enema may be appropriate. For the use of midazolam by subcutaneous infusion using a continuous infusion device, see p. 19 . g. hyoscine), antidepressants and some antiemetics; if possible, an alternative preparation should be considered.

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