disorders.restlessness.tachycardia.taste altered.
vomiting
lPRESCRIBING AND DISPENSING INFORMATION
Preparations with factor VIII inhibitor bypassing activity
are prepared from human plasma.
lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Powder and solvent for solution for injection
▶FEIBA Imuno(Baxalta UK Ltd)
Factor VIII inhibitor bypassing fraction 500 unitFEIBA 500 unit
powder and solvent for solution for injection vials| 1 vialP
£ 390. 00
Powder and solvent for solution for infusion
▶FEIBA Imuno(Baxalta UK Ltd)
Factor VIII inhibitor bypassing fraction 1000 unitFEIBA 1 , 000 unit
powder and solvent for solution for infusion vials| 1 vialP
£ 780. 00
BLOOD AND RELATED PRODUCTS›PLASMA
PRODUCTS
Fresh frozen plasma
lINDICATIONS AND DOSE
Replacement of coagulation factors or other plasma
proteins where their concentration or functional activity
is critically reduced
▶BY INTRAVENOUS INFUSION
▶Child:(consult haematologist)lCONTRA-INDICATIONSAvoid use as a volume expander.
IgA deficiency with confirmed antibodies to IgA
lCAUTIONSCardiac decompensation.need for
compatibility.pulmonary oedema.severe protein S
deficiency (avoid products with low protein S activity e.g.
OctaplasLG®).vaccination against hepatitis A and
hepatitis B may be required
lSIDE-EFFECTS
▶Common or very commonNausea.skin reactions
▶UncommonOedema.vomiting
▶Rare or very rareAgitation.arrhythmias.bronchospasm.
cardio-respiratory distress.chills.fever.hypersensitivity.
hypertension.thromboembolism
lPRESCRIBING AND DISPENSING INFORMATIONFresh frozen
plasma is prepared from the supernatant liquid obtained
by centrifugation of one donation of whole blood.
A preparation of solvent/detergent treated human
plasma (frozen) from pooled donors is available from
Octapharma (OctaplasLG®).
Children under 16 years should only receive virucidally
inactivated preparations of fresh frozen plasma, sourced
from‘low prevalence BSE regions’such as the USA.
lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug.
Infusion
▶OctaplasLG(Octapharma Ltd)
Human plasma proteins 5.75 mg per 1 mlOctaplasLG Blood Group
A Infusion 200 ml bags| 1 bagPs| 10 bagPs
Human plasma proteins 5.75 mg per 1 mlOctaplasLG Blood Group
AB Infusion 200 ml bags| 1 bagPs| 10 bagPs
Human plasma proteins 5.75 mg per 1 mlOctaplasLG Blood Group
B Infusion 200 ml bags| 1 bagPs| 10 bagPs
Human plasma proteins 5.75 mg per 1 mlOctaplasLG Blood Group
O Infusion 200 ml bags| 1 bagPs| 10 bagPs
2.2 Subarachnoid haemorrhage
CALCIUM-CHANNEL BLOCKERS
eiiiiF 108Nimodipine 07-Feb-2018
lDRUG ACTIONNimodipine is a dihydropyridine calcium-
channel blocker.lINDICATIONS AND DOSE
Treatment of vasospasm following subarachnoid
haemorrhage (specialist use only)
▶BY INTRAVENOUS INFUSION
▶Child 1 month–11 years:Initially 15 micrograms/kg/hour
(max. per dose 500 micrograms/hour), increased after
2 hours if no severe decrease in blood pressure;
increased to 30 micrograms/kg/hour (max. per dose
2 mg/hour), continue for at least 5 days (max. 14 days),
use initial dose of 7. 5 micrograms/kg/hour if blood
pressure unstable
▶Child 12–17 years (body-weight up to 70 kg):Initially
0. 5 mg/hour, increased after 2 hours if no severe
decrease in blood pressure; increased to 1 – 2 mg/hour,
continue for at least 5 days (max. 14 days)
▶Child 12–17 years (body-weight 70 kg and above):Initially
up to 1 mg/hour, use dose if blood pressure stable;
increased after 2 hours if no severe decrease in blood
pressure; increased to 1 – 2 mg/hour, continue for at
least 5 days (max. 14 days)
Prevention of vasospasm following subarachnoid
haemorrhage
▶BY MOUTH
▶Child: 0. 9 – 1. 2 mg/kg 6 times a day (max. per dose
60 mg), started within 4 days of haemorrhage and
continued for 21 dayslUNLICENSED USENot licensed for use in children.IMPORTANT SAFETY INFORMATION
SAFE PRACTICE
Nimodipine has been confused with amlodipine; care
must be taken to ensure the correct drug is prescribed
and dispensed.lCAUTIONSCerebral oedema.hypotension.severely raised
intracranial pressure
lINTERACTIONS→Appendix 1 : calcium channel blockers
lSIDE-EFFECTS
▶UncommonThrombocytopenia.vasodilation
▶Rare or very rareBradycardia.ileus
lPREGNANCYManufacturer advises use only if potential
benefit outweighs risk.
lBREAST FEEDINGManufacturer advises avoid—present in
milk.
lHEPATIC IMPAIRMENT
MonitoringElimination reduced in cirrhosis—monitor
blood pressure.
lRENAL IMPAIRMENT
Monitoring▶With intravenous useManufacturer advises
monitor renal function closely in renal impairment.
lDIRECTIONS FOR ADMINISTRATIONAvoid concomitant
administration of nimodipine infusion and tablets.
▶With oral useFor administrationby mouth, tablets may be
crushed or halved but are light sensitive—administer
immediately.
▶With intravenous useForcontinuous intravenous infusion,
administer undilutedviaa Y-piece on a central venous
catheter connected to a running infusion of Glucose 5 %, or
Sodium Chloride 0. 9 %; not to be added to an infusionBNFC 2018 – 2019 Subarachnoid haemorrhage 87
Cardiovascular system2