BNF for Children (BNFC) 2018-2019

(singke) #1
▶Beta-Prograne(Tillomed Laboratories Ltd, Actavis UK Ltd, Teva UK
Ltd)
Propranolol hydrochloride 160 mgBeta-Prograne 160 mg
modified-release capsules| 28 capsuleP£ 6. 11 DT = £ 4. 88
▶Half Beta-Prograne(Teva UK Ltd, Tillomed Laboratories Ltd, Actavis
UK Ltd)
Propranolol hydrochloride 80 mgHalf Beta-Prograne 80 mg
modified-release capsules| 28 capsuleP£ 4. 95 DT = £ 4. 95
Tablet
CAUTIONARY AND ADVISORY LABELS 8
▶Propranolol hydrochloride (Non-proprietary)
Propranolol hydrochloride 10 mgPropranolol 10 mg tablets|
28 tabletP£ 1. 47 DT = £ 0. 89
Propranolol hydrochloride 40 mgPropranolol 40 mg tablets|
28 tabletP£ 1. 85 DT = £ 0. 89
Propranolol hydrochloride 80 mgPropranolol 80 mg tablets|
56 tabletP£ 9. 33 DT = £ 1. 19
Propranolol hydrochloride 160 mgPropranolol 160 mg tablets|
56 tabletP£ 5. 87 DT = £ 5. 87

BETA-ADRENOCEPTOR BLOCKERS›
SELECTIVE
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Atenolol 07-Feb-2018


lINDICATIONS AND DOSE
Hypertension
▶BY MOUTH
▶Neonate: 0. 5 – 2 mg/kg once daily, dose may be given in
2 divided doses.

▶Child 1 month–11 years: 0. 5 – 2 mg/kg once daily, dose
may be given in 2 divided doses, doses higher than
50 mg daily are rarely necessary
▶Child 12–17 years: 25 – 50 mg once daily, dose may be
given in 2 divided doses, higher doses are rarely
necessary
Arrhythmias
▶BY MOUTH
▶Neonate: 0. 5 – 2 mg/kg once daily, dose may be given in
2 divided doses.

▶Child 1 month–11 years: 0. 5 – 2 mg/kg once daily, dose
may be given in 2 divided doses; maximum 100 mg per
day
▶Child 12–17 years: 50 – 100 mg once daily, dose may be
given in 2 divided doses

lUNLICENSED USENot licensed for use in children under
12 years.

IMPORTANT SAFETY INFORMATION
SAFE PRACTICE
Atenolol has been confused with amlodipine; care must
be taken to ensure the correct drug is prescribed and
dispensed.

lINTERACTIONS→Appendix 1 : beta blockers, selective
lSIDE-EFFECTS
▶Common or very commonGastrointestinal disorder
▶Rare or very rareHepatic disorders.mood altered.
psychosis
▶Frequency not knownHypersensitivity.lupus-like
syndrome
lBREAST FEEDINGWater soluble beta-blockers such as
atenolol are present in breast milk in greater amounts than
other beta blockers.
lRENAL IMPAIRMENT
Dose adjustmentsInitially use 50 % of usual dose if
estimated glomerularfiltration rate
10 – 35 mL/minute/ 1. 73 m^2 ; initially use 30 – 50 % of usual
dose if estimated glomerularfiltration rate less than
10 mL/minute/ 1. 73 m^2.

lPATIENT AND CARER ADVICE
Medicines for Children leaflet: Atenolol for hypertension
http://www.medicinesforchildren.org.uk/atenolol-hypertension- 0

lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension, oral solution
Oral solution
▶Atenolol (Non-proprietary)
Atenolol 5 mg per 1 mlAtenolol 25 mg/ 5 ml oral solution sugar free
sugar-free| 300 mlP£ 6. 72 DT = £ 5. 59
Tablet
CAUTIONARY AND ADVISORY LABELS 8
▶Atenolol (Non-proprietary)
Atenolol 25 mgAtenolol 25 mg tablets| 28 tabletP£ 1. 39 DT =
£ 0. 38
Atenolol 50 mgAtenolol 50 mg tablets| 28 tabletP£ 4. 09 DT =
£ 0. 43
Atenolol 100 mgAtenolol 100 mg tablets| 28 tabletP£ 5. 19 DT
=£ 0. 47
▶Tenormin(AstraZeneca UK Ltd)
Atenolol 50 mgTenormin LS 50 mg tablets| 28 tabletP£ 10. 22
DT = £ 0. 43
Atenolol 100 mgTenormin 100 mg tablets| 28 tabletP£ 12. 98
DT = £ 0. 47

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Esmolol hydrochloride


lINDICATIONS AND DOSE
Arrhythmias|Hypertensive emergencies
▶INITIALLY BY INTRAVENOUS INJECTION
▶Child:Loading dose 500 micrograms/kg, to be given
over 1 minute, then (by intravenous infusion)
maintenance 50 micrograms/kg/minute for 4 minutes
(rate reduced if low blood pressure or low heart rate), if
inadequate response, repeat loading dose and increase
maintenance infusion, (by intravenous injection)
loading dose 500 micrograms/kg, given over 1 minute,
then (by intravenous infusion) maintenance
100 micrograms/kg/minute for 4 minutes, if response
still inadequate, repeat loading dose and increase
maintenance infusion, (by intravenous injection)
loading dose 500 micrograms/kg, given over 1 minute,
then (by intravenous infusion) maintenance
150 micrograms/kg/minute for 4 minutes, if response
still inadequate, repeat loading dose and increase
maintenance infusion, (by intravenous injection)
loading dose 500 micrograms/kg, given over 1 minute,
then (by intravenous infusion) maintenance
200 micrograms/kg/minute for 4 minutes, doses over
300 micrograms/kg/minute not recommended
Tetralogy of Fallot
▶INITIALLY BY INTRAVENOUS INJECTION
▶Neonate:Initially 600 micrograms/kg, dose to be given
over 1 – 2 minutes, then (by intravenous infusion)
300 – 900 micrograms/kg/minute if required.

lUNLICENSED USENot licensed for use in children.
lINTERACTIONS→Appendix 1 : beta blockers, selective
lSIDE-EFFECTS
▶Common or very commonAnxiety.appetite decreased.
concentration impaired.drowsiness
▶UncommonChills.costochondritis.dyspepsia.fever.
flushing.nasal congestion.oedema.pain.pallor.
pulmonary oedema.respiratory disorders.seizure.speech
disorder.taste altered.thinking abnormal
▶Rare or very rareCardiac arrest
▶Frequency not knownAngioedema.coronary vasospasm.
hyperkalaemia.metabolic acidosis

106 Blood pressure conditions BNFC 2018 – 2019


Cardiovascular system

2

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