[VIP] British National Formulary (BNF) 66 September 2013-March 2014

British National Formulary (BNF) 66 September 2013-March 2014

British National Formulary (BNF) 66 September 2013-March 2014

Publication Date: November 1, 2013 | ISBN-10: 0857110853 | ISBN-13: 978-0857110855 | Edition: 1

The BNF is a joint publication of the British Medical
Association and the Royal Pharmaceutical Society. It is
published under the authority of a Joint Formulary
Committee which comprises representatives of the
two professional bodies, the UK Health Departments,
the Medicines and Healthcare products Regulatory
Agency, and a national guideline producer. The Dental
Advisory Group oversees the preparation of advice on
the drug management of dental and oral conditions; the
Group includes representatives of the British Dental
Association and a representative from the UK Health
Departments. The Nurse Prescribers’ Advisory Group
advises on the content relevant to nurses and includes
representatives from different parts of the nursing community and from the UK Health Departments.
The BNF aims to provide prescribers, pharmacists, and
other healthcare professionals with sound up-to-date
information about the use of medicines.
The BNF includes key information on the selection,
prescribing, dispensing and administration of medicines. Medicines generally prescribed in the UK are
covered and those considered less suitable for prescribing are clearly identified. Little or no information
is included on medicines promoted for purchase by the
public.
Information on drugs is drawn from the manufacturers’
product literature, medical and pharmaceutical literature, UK health departments, regulatory authorities, and
professional bodies. Advice is constructed from clinical
literature and reflects, as far as possible, an evaluation of
the evidence from diverse sources. The BNF also takes
account of authoritative national guidelines and emerging safety concerns. In addition, the editorial team
receives advice on all therapeutic areas from expert
clinicians; this ensures that the BNF’s recommendations
are relevant to practice.
The BNF is designed as a digest for rapid reference and
it may not always include all the information necessary
for prescribing and dispensing. Also, less detail is given
on areas such as obstetrics, malignant disease, and
anaesthesia since it is expected that those undertaking
treatment will have specialist knowledge and access to
specialist literature. BNF for Childrenshould be consulted for detailed information on the use of medicines
in children. The BNF should be interpreted in the light of
professional knowledge and supplemented as necessary
by specialised publications and by reference to the
product literature. Information is also available from
medicines information services (see inside front cover).
It isimportant to use the most recent BNF information
for making clinical decisions. The print edition of the
BNF is updated in March and September each year.
Monthly updates are provided online via the BNF Publications website bnf.org, MedicinesComplete, and the
NHS Evidence portal. The more important changes for
this edition are listed on p. xvii; changes listed online are
cumulative (from one print edition to the next), and can
be printed off each month to show the main changes
since the last print edition as an aide memoire for those
using print copies.
The website (bnf.org) includes additional information of
relevance to healthcare professionals. Other digital formats of the BNF—including versions for mobile dev.

 

Preface………………………………………………………………………………………………………………………………….iii
Acknowledgements………………………………………………………………………………………………………………….v
How the BNF is constructed …………………………………………………………………………………………………….ix
How to use the BNF ………………………………………………………………………………………………………………..xi
Changes for this edition……………………………………………………………………………………………………….xvii
Significant changes………………………………………………………………………………………………………….xvii
Dose changes …………………………………………………………………………………………………………………xvii
Classification changes ……………………………………………………………………………………………………..xvii
Deleted preparations ……………………………………………………………………………………………………….xvii
New preparations included in this edition …………………………………………………………………………..xviii
Guidance on prescribing…………………………………………………………………………………………………………..1
General guidance………………………………………………………………………………………………………………..1
Prescription writing……………………………………………………………………………………………………………..5
Emergency supply of medicines …………………………………………………………………………………………….7
Controlled Drugs and drug dependence ………………………………………………………………………………….8
Adverse reactions to drugs …………………………………………………………………………………………………12
Prescribing for children………………………………………………………………………………………………………15
Prescribing in hepatic impairment………………………………………………………………………………………..17
Prescribing in renal impairment …………………………………………………………………………………………..17
Prescribing in pregnancy…………………………………………………………………………………………………….19
Prescribing in breast-feeding ………………………………………………………………………………………………19
Prescribing in palliative care ……………………………………………………………………………………………….20
Prescribing for the elderly…………………………………………………………………………………………………..25
Prescribing in dental practice………………………………………………………………………………………………27
Drugs and sport ………………………………………………………………………………………………………………..32
Emergency treatment of poisoning …………………………………………………………………………………………33
Notes on drugs and preparations
1: Gastro-intestinal system…………………………………………………………………………………………….44
2: Cardiovascular system ……………………………………………………………………………………………….83
3: Respiratory system ………………………………………………………………………………………………….177
4: Central nervous system…………………………………………………………………………………………….218
5: Infections ……………………………………………………………………………………………………………….338
6: Endocrine system…………………………………………………………………………………………………….443
7: Obstetrics, gynaecology, and urinary-tract disorders …………………………………………………..512
8: Malignant disease and immunosuppression ……………………………………………………………….546
9: Nutrition and blood ………………………………………………………………………………………………….620
10: Musculoskeletal and joint diseases …………………………………………………………………………..674
11: Eye ………………………………………………………………………………………………………………………..713
12: Ear, nose, and oropharynx ………………………………………………………………………………………..736
13: Skin……………………………………………………………………………………………………………………….751
14: Immunological products and vaccines………………………………………………………………………..798
15: Anaesthesia ……………………………………………………………………………………………………………828
Appendices and indices
Appendix 1: Interactions……………………………………………………………………………………………………852
Appendix 2: Borderline substances …………………………………………………………………………………….955
Appendix 3: Cautionary and advisory labels for dispensed medicines…………………………………….991
Appendix 4: Intravenous additives ……………………………………………………………………………………1007
Appendix 5: Wound management products and elasticated garments …………………………………..1017
Dental Practitioners’ Formulary ……………………………………………………………………………………….1044
Nurse Prescribers’ Formulary ………………………………………………………………………………………….1046
Non-medical prescribing ………………………………………………………………………………………………..1050
Index of manufacturers ………………………………………………………………………………………………….1051
Index ………………………………………………………………………………………………………………………….1061
Medical emergencies in the community……………………………………………………

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