100 mcg q12hr may be considered in patients who have poorer asthma control or previously required higher-than-usual dosages of inhaled corticosteroids Patients on long-term PO corticosteroid therapy: Do not reduce prednisone faster than 2.5-5 mg/day on weekly basis, beginning after Nasal congestion (8%) Sinusitis or sinus infection (4-7%) Cough (4-6%) Bronchitis (2-6%) Hoarseness or dysphonia (2-6%) Allergic rhinitis (5%) Nasal discharge (5%) Upper respiratory inflammation (2-5%) Muscle injury (≤5%) Gastrointestinal (GI) discomfort or pain (1-4%) Hypersensitivity reactions (including anaphylaxis, angioedema, rash, urticaria) Respiratory: Rhinitis, rhinorrhea or postnasal drip, nasal sinus disorders, laryngitis GI: Diarrhea, loss of taste, viral infections, dyspeptic symptoms, discomfort, pain, hyposalivation Muscular: Musculoskeletal pain, stiffness, tightness, rigidity, injuries, soreness Other: Dizziness, migraine, fever, viral infection, pain, chest symptoms, viral skin infections, soft tissue injuries, urinary infections Special senses: Aphonia, facial and oropharyngeal edema, throat soreness, irritation, cataracts Endocrine: Cushingoid features, growth velocity reduction in children and adolescents, hyperglycemia, osteoporosis, weight gain GI: Dental caries, tooth discoloration, esophageal candidiasis Psychiatry: Agitation, aggression, anxiety, depression, restlessness; behavioral changes, including hyperactivity and irritability (rarely and primarily in children) Immunologic: Immediate and delayed hypersensitivity reactions, including urticaria, anaphylaxis, rash, angioedema, bronchospasm Respiratory: Asthma exacerbation, chest tightness, cough, dyspnea, immediate and delayed bronchospasm, paradoxical bronchospasm, pneumonia, wheezing Skin: Contusions, cutaneous hypersensitivity reactions, ecchymoses, pruritus Rare cases of systemic eosinophilic conditions (some with features of vasculitis consistent with Churg-Strauss syndrome, which is often treated with systemic corticosteroids) Eye: Cataracts, blurred vision, and central serous chorioretinopathy Nervous system disorders: Tremor Respiratory tract tuberculosis, untreated fungal or bacterial infections, viral or parasitic infections, ocular herpes simplex; care must be taken to avoid exposure Nasal septum perforation, epistaxis, wheezing Cataracts, glaucoma, increased intraocular pressure may occur; monitor for glaucoma and cataracts Risk of more serious or fatal course of chickenpox or measles in susceptible patients (eg, unvaccinated or immunologically unexposed individuals); care must be taken to avoid exposure Hypercorticism and adrenal suppression may occur with high dosages or at regular dosage in susceptible individuals; if such changes occur, taper withdrawal gradually May decrease growth velocity in children; monitor growth of pediatric patients Assess for decrease in bone mineral density initially and periodically thereafter Use with caution in immunocompromised patients Prolonged use of corticosteroids may increase incidence of secondary infection Risk of infections of nose and pharynx, including Candida albicans; must rinse mouth after inhalation to reduce risk Excessive use may suppress hypothalamic-pituitary-adrenal function; monitor closely, especially postoperatively or during periods of stress During periods of stress or severe status asthmaticus, supplementary systemic corticosteroids may be immediately required; patient should carry warning card indicating possible need for supplementary systemic steroids in such emergencies There are no randomized clinical studies in pregnant women; in women with poorly or moderately controlled asthma, there is increased risk of several perinatal adverse outcomes (eg, pre-eclampsia in the mother, prematurity, low birth weight, and small for gestational age in the neonate;) Pregnant women with asthma should be closely monitored and medication adjusted as necessary to maintain optimal asthma control Fluticasone propionate concentrations in plasma after inhaled therapeutic doses are low; concentrations in human breast milk are likely to be correspondingly low Developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on the breastfed child from the drug or from underlying maternal condition Anti-inflammatory corticosteroid; exact mechanism of action is unknown, but agent has been shown to exhibit anti-inflammatory effect on neutrophils, eosinophils, macrophages, mast cells, lymphocytes, and mediators (histamine, leukotrienes, cytokines, eicosanoids) The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. Amber guidance for IBD in children (azathioprine) Azathioprine PIL for IBD Azathioprine: patient information leaflet - children and young people with rheumatological conditions Azathioprine-Mercaptopurine PIL for IBD LTHT Medication Safety Alert (June 17) - patients with underlying cardiac disease - practical guidance MHRA Drug Safety Update (Feb 17): risk of serious adverse effects in patients with underlying cardiac disease National Paediatric IV Administration Guide (Medusa) - hyoscine butylbromide Amber Drug Guidance: Mercaptopurine for IBD Azathioprine-Mercaptopurine PIL for IBD Patient information leaflet: mercaptopurine for inflammatory bowel disease in children and young people UK guidelines: IBD in children Amber Drug Guidance: Inflammatory Bowel Disease in Children Aminosalicylates-5-asas PIL for IBD Mesalazine Foam Enema PIL for IBD Mesalazine Liquid Enema PIL for IBD Mesalazine oral PIL for IBD Mesalazine suppositories PIL for IBD UK Guidelines: IBD in children supporting information (sildenafil) Drug Safety Update (Nov 18) Sildenafil (Revatio and Viagra): reports of persistent pulmonary hypertension of the newborn (PPHN) following in-utero exposure in a clinical trial on intrauterine growth restriction Warning: Paracetamol, Metronidazole and Sodium Chloride infusions look very similar (Oct 17) LTHT Paediatric Acute Pain Management manual Paediatric IV paracetamol dosing table (practice within LTHT) IV paracetamol in paediatrics - 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) - flucloxacillin LTHT Cystic Fibrosis IV antibiotics guideline (adults and children) LTHT Cystic Fibrosis Oral antibiotics guideline (adults and children) LTHT: Cardiac Surgery in Children - Guideline for antimicrobial prophylaxis LTHT Cystic Fibrosis IV antimicrobial guidelines (adults and children) May 2018 Caution in Use - some product distributed without water for injection National Paediatric IV administration monograph - teicoplanin Paediatric cardiac surgery antibiotic prophylaxis guideline LTHT prescription chart - vancomycin (paediatric) National Paediatric IV Administration Guide (Medusa) - vancomycin Paediatric vancomycin prescribing guidance CVC infection guideline for children on TPN LTHT Cystic Fibrosis Inhaled Therapy (adults and children) LTHT Cystic Fibrosis IV antimicrobial guidelines (adults and children) Anterior Pituitary Function Test for Children (Glucagon Stimulation Test) Clonidine GH Stimulation Test for Children Corticotrophin Releasing Hormone (CRH) Test in children Cortisol profile test in children Gonadotrophin Releasing Hormone (Gn RH) test for children Human chorionic gonadotropin (h CG) stimulation test for children Low dose (1 microgram) Synacthen test for suspected adrenal insufficiency in children Multiple Endocrine Neoplasia (MEN) 2a screening for children Oral glucose tolerance test for the diagnosis of Diabetes Mellitus in children Oral glucose tolerance test for the diagnosis of Growth Hormone excess in children Standard Synacthen test for Congenital Adrenal Hyperplasia in children Water Deprivation test for suspected Diabetes Insipidus in children Amber Drug Guidance: Estradiol Valerate Tablets for Sexual Maturation and Maintenance in Females BSPED: Hormone Supplementation For Pubertal Induction In Girls PIL - 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.
Read the Patient Information Leaflet if available from your pharmacist before you start taking fluconazole and each time you get a refill. If you have any questions, ask your doctor or pharmacist. Take this medication by mouth with or without food as directed by your doctor, usually once daily. If you are taking the liquid suspension form of this medication, shake the bottle well before each dose. Carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. Dosage is based on your medical condition and response to treatment. Generally in children, the dose should not exceed 600 milligrams daily unless directed by the doctor. Birleşmiş Milletler’e bağlı INTERSTENO Uluslararası Bilgi İşlem ve İletişim Federasyonu tarafından düzenlenen ve dünya genelinde katılan on binlerce yarışçı elemeleri sonucunda yapılan bu yılın Dünya İnternet Klavye Şampiyonası sonuçlandı. Finallerde derece alabilen 1247 yarışçı arasında Türkler, 1 şampiyonluk 5 ikincilik 6 üçüncülük alarak takım sıralamasında bu yıl da Dünya Şampiyonluğunu kazandı. Anadil ve çok dilli (17 dil) ayrımıyla iki yarış türünde ve 4 yaş kategorisi ile yapılan toplam 8 yarıştaki en iyi 3’er yarışçıya verilecek 24 madalyanın 12’sini Türkler kazanarak takım halinde de Dünya Şampiyonu oldu. Tüm kategoriler genelinde ülke sıralamalarında, Türkiye 12 madalya, Çek Cumhuriyeti 3 madalya, Japonya 3 madalya, İtalya 2 madalya, ABD 2 madalya, İspanya 2 madalya kazandılar. Türk Millî Takımı, ilk ona giren10’ar yarışçıdan oluşan Onur ve Teşvik Tablosunda aldığı puanlara göre 8 kategoride, takım halinde 5 Dünya Şampiyonluğu, 2 Dünya İkinciliği ve 1 Dünya Dördüncülüğü elde etmiştir. Bu derecelerle de Millî Takımımız takım halinde de dünyanın en başarılı ekibi olmuştur. Şampiyonada Madalya Alan yarışçılarımızın isimleri aşağıda belirtilmiştir.
Notes The Leeds Children's Hospital Formulary is laid out in BNF chapter order. There are custom indexes for the following specialist areas Paediatric Intensive Care Unit PICU Medscape - Flovent Diskus, Flovent HFA fluticasone inhaled, frequency-based adverse effects, comprehensive interactions, contraindications, pregnancy.