From the new nutrition tables in BNFC to the browseable index on the online versions of BNF and BNFC, a number of significant changes and developments that we report today have been made in response to feedback from our users. We value constructive criticism and suggestions from healthcare professionals and are now asking doctors to join our virtual users' group.
We encourage you to complete the BNFC case study which has been written in conjunction with our experts in infectious diseases and nutrition. Today's tip will help you determine the licensed status of a drug in BNFC.
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| BNFC UPDATE ON SIGNIFICANT CHANGES |
Acute asthma
A new table summarises information on the management of acute asthma in children. The table includes key clinical parameters to assess the severity of each exacerbation, and provides advice on the treatment of moderate, severe, and life-threatening acute asthma. For further information click on acute asthma
Oseltamivir in children under 1 year
Safety data on the use of oseltamivir in children under 1 year of age is limited and it is not licensed for use in this age group. Furthermore, oseltamivir may be ineffective in neonates and very young infants because they may not be able to metabolise oseltamivir to its active form. BNFC recommends that in exceptional circumstances, oseltamivir can be used under specialist supervision for the treatment or post-exposure prophylaxis of influenza in children under 1 year of age. The Department of Health has advised that, during a pandemic, treatment of children under 1 year with oseltamivir can be overseen by healthcare professionals experienced in assessing children. For further information click on influenza
Otitis media
Most uncomplicated cases of acute otitis media resolve without antibacterial treatment. In children without systemic features, antibacterial treatment may be started after 72 hours if there is no improvement. Guidance on earlier antibacterial treatment of otitis media has been updated in BNFC. Earlier treatment can be considered if the condition deteriorates, if the child is systemically unwell, if the child is at high risk of serious complications (e.g. in immunosuppression, cystic fibrosis), if mastoiditis is present, or in children under 2 years of age with bilateral otitis media. Perforation of the tympanic membrane in children with acute otitis media usually resolves spontaneously without treatment, but a systemic antibacterial can be given if there is no improvement. For further information click on otitis media
Nutrition
Which formula feed is suitable for an infant with lactose intolerance? Can I switch an infant from Infasoy® to Wysoy®? New tables on ACBS-approved enteral feeds, nutritional supplements, and special feeds will make it easier to compare and select products for children with different nutritional requirements. The tables on enteral feeds and nutritional supplements are separated according to their energy and protein content. For further information click on Appendix 2
Melatonin
What's the role of melatonin in the treatment of childhood sleep disorders? Clinical experience suggests that melatonin may be of value for treating sleep onset insomnia and delayed sleep phase syndrome in children with conditions such as visual impairment, cerebral palsy, ADHD, autism, and learning difficulties. Little is known about its long-term effects in children, but there is a theoretical basis for an effect on sexual development. Treatment with melatonin should be initiated and supervised by a specialist, but may be continued by GPs under a shared-care arrangement. The need for continuing melatonin therapy should be reviewed every 6 months. For further information click on melatonin
Immunological products and vaccines
Chapter 14 on Immunological Products and Vaccines has been updated and reformatted. The Immunisation Schedule has been tabulated for ease of use. For further information click on chapter 14 and immunisation schedule
Caffeine
Caffeine (as caffeine base) is now licensed for the treatment of apnoea of prematurity. To avoid dosage errors, BNFC recommends that the dose should always be expressed in terms of caffeine base and not caffeine citrate. For further information click on caffeine
Intravenous infusions for neonatal intensive care
A new appendix on intravenous infusions for neonatal intensive care has been added to BNFC. As well as providing practical information on preparing intravenous infusions in this setting, it includes a table of detailed administration instructions for key drugs. Drug-specific information can also be found in the Administration section of the monographs. For further information click on neonatal intensive care
How BNFC is constructed
This new section provides valuable insight into how the national prescribing resource is constructed. For further information click on how BNFC is constructed
Other changes
To review other changes in BNFC 2009, click on changes
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| BNFC CASE STUDY |
| To help you put BNFC advice on otitis media, immunisations, and nutrition into practice, please follow this link to a BNFC case study.
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| TIPS ON USING BNFC EFFECTIVELY |
For guidance on how to identify the licensed status of a drug in BNFC, please click here.
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| BNF AND BNFC DIGITAL DEVELOPMENTS |
Index added to online versions of BNF and BNFC
The BNF and BNFC online are now available with a browseable index. The index provides access to the content via an additional route that will be familiar to many readers who have traditionally used print versions of BNF publications. In addition, users who are unsure of the precise spelling of a particular drug name or condition may feel more comfortable browsing the index, rather than relying on the misspelling algorithm that is part of the search function.
The index complements the existing search functionality by providing links to entries in the main body of the BNF/BNFC text, to Appendixes 2 and 4 (Borderline Substances and Intravenous Infusions for Neonatal Intensive Care) in BNFC, and to information in Appendixes 6, 7, and 8 (Intravenous Additives, Borderline Substances, and Wound Management Products, respectively) in the BNF. Advice in the other appendixes is not indexed, but these sections can be easily accessed by browsing the main hierarchy, by using the full text search, or by using the interactions search engine.
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| JOIN THE DOCTORS' VIRTUAL USER GROUP |
BNF publications are in the process of setting up Virtual User Groups for various health professions to obtain direct feedback, as well as more general experiences on the day to day use of the BNF or BNFC.
Questionnaires that can be completed online will be sent out 2-3 times a year.
Practising doctors who are interested in contributing should email their details to: virtualusers@bnf.org
In the subject line, please include 'Doctor' and indicate whether your interest is in:
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BNF only
- BNFC only
- both BNF & BNFC
We look forward to hearing from you.
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| FEEDBACK ON OUR E-NEWSLETTER |
Please let us know if there are any issues that you would like us to address in e-newsletters. We welcome your feedback, if you have any comments or suggestions please let us know at enewsletter@bnf.org.
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