More specific dosages introduced for children’s paracetamol
June 29, 2011 by admin
The Medicines and Healthcare products Regulatory Agency (MHRA) has announced new dosing advice for children’s medicines containing paracetamol that:
- replaces the current three age bands with seven: 3-6 months, 6-24 months, 2-4 years, 4-6 years, 6-8 years, 8-10 years and 10-12 years.
- defines a single dose for each age band.
Products should carry these instructions by the end of the year. See here for details.
Clarity needed about the role of non-medical prescribing leads
June 8, 2011 by admin
Non-medical prescribing leads (NMP leads) make a significant contribution to the development of NMP and its oversight within Trusts, despite lack of clarity about the role and workload and other issues, according to this report of an interview study with 28 NMP leads across one Strategic Health Authority.
The role of the NMP lead included: information and communication between the Trust and prescribers; promoting and co-ordinating NMP and integrating it into service planning; clinical governance; and support and training. There was inconsistency and lack of clarity about the functions and scope of the NMP lead, and dedicated time for the role was often insufficient. The authors conclude that there should be clear national guidelines about the responsibilities, role and workload of NMP leads, and that greater consistency is also needed in clinical governance systems as NMP expands. In particular, all NMPs should be able to review their prescribing data.
Conversely, where strategies for the development of NMP did exist, it was more likely to be embedded within organisations, and practitioners faced fewer barriers.
Courtenay M, Carey N and Stenner K. Non medical prescribing leads’ views on their role and the implementation of non medical prescribing from a multi-organisational perspective. BMC Health Services Research 2011; 11:142.
http://dx.doi.org/10.1186/1472-6963-11-142
Paracetamol prescribing in children
June 8, 2011 by admin
There are ‘relatively high levels of potential overdosing in the youngest children and potential underdosing in the oldest children’ in paracetamol prescribing in primary care, according to the conclusions of this study. It analysed a year’s data about paracetamol prescriptions in children aged 0-12 in general practices in Scotland.
About one-fifth of the paracetamol prescriptions were defined as off-label - being outside the BNF for Children age and dose recommendations - with incorrect doses being the most common reason. In addition, another 15% of prescriptions did not have dosage instructions.
The risk of over-dosing in young children carries a risk of toxicity, particularly as parents and carers often use paracetamol for children before they seek professional advice. For older children receiving doses that are too low, there is a risk of treatment failure and prescribing not being cost-effective.
Kazouini A et al. Paracetamol prescribing in primary care: too little and too much? Br J Clin Phamacol 2011; in press.
http://dx.doi.org/10.1111/j.1365-2125.2011.03993.x
Antipyretics should not be used prophylactically for vaccination
June 8, 2011 by admin
Ibuprofen and paracetamol should not be used routinely to prevent the fever that often follows vaccination in children, according to updated recommendations in the Department of Health’s Green Book (see here). There is evidence that this can reduce antibody responses in some cases, so the advice is now that these medicines should be used to treat but not to prevent reactions.
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