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Medicines Safety Alert (LTHT access only) May 2014: paediatric paracetamol dosing in acute pain - memo The Safe Use of Paracetamol Prescribing and Administration Guide (phenytoin) Phenytoin Prescribing and Administration Guide (general paediatric medicine) Medication Safety Alert: Risk of death and severe harm from error with injectable phenytoin (LTHT access only) Amber Drug Guidance - antiepileptics in children BNFC dosing (phenytoin) LTHT: avoid switching between brands of antiepileptics phenytoin infatabs, capsules and liquid have different bioavailabilities Prescribing and Administration Guide (amoxicillin) BNFc oral dosing information (amoxicillin) LTHT Cystic Fibrosis Oral Antibiotics guidelines (adults and children) National Paediatric IV Administration Guide (Medusa) - amoxicillin Ongoing supply shortage - alternatives LTHT aseptics order form (paediatric CF) LTHT Cystic Fibrosis Inhaled Therapy (adults and children) LTHT Cystic Fibrosis IV Antibiotic guidelines (adults and children) Prescribing and Administration Guide (flucloxacillin) BNFc oral dosing information (flucloxacillin) National Paediatric IV Administration Guide (Medusa) - 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estradiol valerate (Gender Identity Service) (LTHT access only) NHSE: Medical care for gender variant children and young people Northern Gender Identity Development Service - info for GPs PIL - estradiol valerate (Gender Identity Service) (LTHT access only) PIL - ethinylestradiol (Gender Identity Service) (LTHT access only) PIL - Decapeptyl (Gender Identity Service) (LTHT access only) PIL - Gonapeptyl (Gender Identity Service) (LTHT access only) PIL - oestrogen patches (Evorel) (Gender Identity Service) (LTHT access only) PIL - testosterone (Gender Identity Service) (LTHT access only) Testosterone gel: alternatives during shortage (Mar 18) Prescribing and Administration Guide (insulin) LTHT chart - multiple daily dose insulin (paediatric) LTHT Chart - Paediatiric Insulin Standard Sliding Scale National Paediatric IV Administration Guide (Medusa) - insulin Guidelines Diabetic emergencies and Intercurrent Illness (NHS access only) Management of DKA in paediatric patients (NHS access only) Management of hyperglycaemia in non-diabetic critically ill children Peri-operative management of insulin (paediatrics) (NHS access only) Information Guidance on adding 50% glucose to iv fluids to increase glucose concentrations Newsletter - insulin use in paediatric patients (information) (LTHT access only) Amber Drug Guidance: Evorel for Sexual Maturation and Maintenance in Females (Children) BSPED: Hormone Supplementation For Pubertal Induction In Girls PIL: oestrogen patches (Gender Identity Service) (LTHT access only) Paediatric rheumatology administration guide (infliximab) Patient information leaflet: infliximab infusions for juvenile arthritis and uveitis in children and young people Infliximab PIL for paediatric IBD Paediatric Infliximab dose banding Paediatric Rheumatology prescribing guidance: Infliximab UK Guidelines: IBD in children MHRA Drug Safety Update Apr 2014: Tumour necrosis factor alpha inhibitors: risk of tuberculosisscreen all patients before starting treatment and monitor them closely Amber Drug Guidance - non-oncology indications in paediatrics LTHT Paediatric Rheumatology Intravenous Methotrexate administration guide Paediatric Rheumatology prescribing guidance: methotrexate IV Paediatric Rheumatology prescribing guidance: methotrexate SC Patient Information Leaflt: methotrexate injection for juvenile idiopathic arthritis/other paediatric rheumatology indications Patient Information Leaflt: methotrexate tablets for juvenile idiopathic arthritis/other paediatric rheumatology indications UK Guidelines: IBD in children Amber Drug Guidance - sulfasalazine (paediatric rheumatology) LTHT: sulfasalazine - interference with ALT assay (updated Oct 17) Patient Information leaflet: sulfasalazine in juvenile idiopathic arthritis in children and young people Neonatal BNF-c monograph (oral) Neonatal Prescribing and Administration Monograph - acute liver injury (IV) Neonatal Prescribing and Administration monograph - meconium ileus (oral and rectal administration) Fluids available on neonatal units Guidance on adding glucose 50% to infusion fluids LTHT: Intravenous Fluids and How to Prescribe them on Neonatal Unit Potassium-containing fluids available within LTHT Drugs used in inherited metabolic disorders Amber Drug Guidance: Paediatric Levocarnitine Solution for the Treatment of Carnitine Deficiency British Inherited Metabolic Disease Group - guidelines for prescribers Dietary products used in metabolic disorders Oral dinoprostone may be considered in extreme circumstances as an alternative to continuous intravenous infusion of alprostadil if intravenous access is lost. Before commencing this must be discussed with a paediatric cardiology and / or neonatal consultant. Dosage and administration guidance is available on L51 HDU drug file. Amber Level 1- Specialist Recommendation These medicines are considered suitable for GP prescribing following specialist recommendation. There is no requirement for full Amber Drug Guidance. Generic Amber Level 1 Drug Guidance detailing responsibilities and information sources is available here Amber Level 2- Specialist Initiation but no monitoring requirements These medicines are considered suitable for GP prescribing following specialist initiation, including titration of dose and assessment of efficacy. Some Amber Level 2 products will have an associated Amber Level 2 Drug Guidance document, available by clicking on the traffic light symbol to the right of the drug name. prednisone equivalent dose Other uses include skin disorders, Crohn's disease, ulcerative colitis, and eosinophilic esophagitis. Common side effects when inhaled include upper respiratory tract infections, sinusitis, thrush, and cough. Fluticasone is used by powder or aerosol inhalation for the prophylaxis of asthma, the nasal spray is used for prophylaxis and treatment of allergic rhinitis, nasal drops are used in the treatment of nasal polyps, and creams and ointments are applied topically in the treatment of various skin disorders. It can be given orally in the treatment of Crohn’s disease and ulcerative colitis. If taken correctly, the nasal spray and oral inhaler formulation have fewer corticosteroid side effects than the tablet formulation because they limit systemic (blood) absorption. Common side effects may include nasal irritation (burning, stinging, bleeding), headache, upset stomach (nausea, vomiting), and diarrhea. Rare side effects include infection (evidenced by, e.g., fever, sore throat, and cough), vision problems, severe swelling, hoarse voice, and difficulty breathing or swallowing.

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