Flower Faeries Masks and Wings

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Example text

G. cytotoxic drugs and drugs used in anaesthesia). Where causality has not been established, side-effects in the manufacturers’ literature may be omitted from the BNF for Children. In the product literature the frequency of side-effects is generally described as follows: Very common greater than 1 in 10 Common 1 in 100 to 1 in 10 Uncommon [‘less commonly’ in BNF for Children] 1 in 1000 to 1 in 100 Rare 1 in 10 000 to 1 in 1000 Very rare less than 1 in 10 000 Special problems Symptoms Children may be poor at expressing the symptoms of an adverse drug reaction and parental opinion may be required.

Pain control Diamorphine (p. 252) is the preferred opioid since its high solubility permits a large dose to be given in a small volume (see under Mixing and Compatibility). The table on p. 29 shows approximate equivalent doses of morphine and diamorphine. Restlessness and confusion Haloperidol has little sedative effect. Levomepromazine (methotrimeprazine) (p. 219) has a sedative effect. Midazolam is a sedative and an antiepileptic that may be suitable for a very restless patient. Mixing and compatibility The general principle that injections should be given into separate sites (and should not be mixed) does not apply to the use of syringe BNFC 2009 Prescribing in palliative care 29 drivers in palliative care.

3. Mixtures of haloperidol and diamorphine are likely to precipitate after 24 hours if haloperidol concentration is above 2 mg/mL. 4. Under some conditions, infusions containing metoclopramide become discoloured; such solutions should be discarded. General guidance Subcutaneous infusion solution should be monitored regularly both to check for precipitation (and discoloration) and to ensure that the infusion is running at the correct rate. 30 Prescribing in palliative care BNFC 2009 General guidance Problems encountered with syringe drivers The following are problems that may be encountered with syringe drivers and the action that should be taken: .

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