BNF Chapter 15

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Anaesthetics

BNF CODE – 15.1.1
INTRAVENOUS ANAESTHETICSNOTES
THIOPENTAL SODIUM500 mg InjectionOccasional use induction (epileptics / day cases)
ETOMIDATE20 mg in 10 ml InjectionOccasional use induction (minimum effect on BP)
KETAMINE10 mg / ml Injection  20ml Vial

50 mg /ml Injection  10ml Vial

100 mg /ml Injection  10ml Vial

Occasionally used – can be given IM
Also used to sedate for procedures
PROPOFOL1% Intravenous Infusion  20ml Amp

2% Intravenous Infusion  50ml Vial

1%  50ml Pre-Filled Syringe

2%  50ml Pre-Filled Syringe

General 1st line induction
BNF CODE – 15.1.3
ANTIMUSCARINIC PREMEDICATION DRUGSNOTES
ATROPINE SULPHATE200 micrograms / ml Pre-filled Syringe 5ml

600 micrograms in 1ml Amp

1st  line peri-operative antimuscurinic Also used for bradycardias
GLYCOPYRRONIUM BROMIDE 200 microgram / ml
1ml & 3ml Ampoules
ROBINUL2nd line peri-operative antimuscurinic
(For drying secretions, difficult ENT cases, laryngoscopy / fibre-optic intubation)
GLYCOPYRRONIUM BROMIDE  + NEOSTIGMINE500 microgram +2.5mg in 1ml AmpROBINUL – NEOSTIGMINE2nd line peri-operative antimuscurinic
(For drying secretions, difficult ENT cases, laryngoscopy / fibre-optic intubation)
HYOSCINE HYDROBROMIDE400 micrograms / ml

600 micrograms / ml

HYOSCINE-N-BUTYLBROMIDE20mg / ml
BNF CODE – 15.1.4.1
ANXIOLYTICS & NEUROLEPTICSNOTES
Important Info
SEDATION ON ITU1) Midazolam & Morphine (longer term with analgesia)

2) Midazolam & Fentanyl (medium term with analgesia)

3) Propofol (short term no analgesia)

DIAZEPAM2mg, 5mg Tablets

2mg / 5ml, 5mg/5ml Oral Liquid

10mg / 5ml FORTE Oral Liquid

10 mg in 2ml Injection

10mg in 2ml EMULSION Injection

2.5mg, 5mg, 10mg Rectubes

LORAZEPAM1mg tablets

4mg / ml Injection

MIDAZOLAM1mg / ml Injection1st line benzo for sedation
MIDAZOLAM 40mg in 1ml & Lidocaine 20mg in 1ml Intra-Nasal Solution
[Specials order from Guys & St.Thomas 5×0.5ml ampoules]
RESTRICTED Adults Special Care Dentistry
[Unlicensed Use / Special]DENTAL PROTOCOL Sedation_for_patients_with_special_needs
BNF CODE – 15.1.4.2

PERIOPERATIVE NON-OPIOID ANALGESICS

NOTES
KETOROLAC TROMETAMOL10 mg in 1ml Injection

30 mg in 1ml Injection

BNF CODE – 15.1.4.3
PERIOPERATIVE OPIOID ANALGESICSNOTES
ALFENTANIL1mg in 2 ml Injection

5 mg in 10 ml Injection

5 mg in 1 ml Injection

Some use – IV maintenance
FENTANYL100 micrograms in 2ml Injection

500 micrograms in 10ml Injection

1st line use – IV induction & some maintenance
FENTANYL + BUPIVACAINE 2microgram per ml +0.1% (20ml Syringe) Injection

2microgram per ml & 0.1% (250ml) STERIFLEX Infusion

Unlicensed

RESTRICTED USE (ITU) Reserved for the following groups of Patients on ITU (THEATRES are exempt from this restriction):

  1. short-term sedation
  2. difficult/complicated patients
  3. head injury patients with low GCS
  4. severe hepatic / renal failure
FENTANYL + LEVOBUPIVICAINE2micrograms/ml + 0.1% in 250ml infusionUnlicensed

RESTRICTED USE: Labour analgesia via lumbar epidural

BNF CODE – 15.1.5
MUSCLE RELAXANTSNOTES
ATRACURIUM BESYLATE25 mg in 2.5ml Injection

50 mg in 5ml Injection

250 mg in 25ml Injection

General use – effects wear off quickly
MIVACURIUM10 mg in 5ml Injection

20 mg in 10 ml Injection

Occasional use – short acting
PANCURONIUM BROMIDE2mg/ml 2ml AmpouleRESTRICTED use – for ventilated patients                   (Neonatal Unit)
ROCURONIUM BROMIDE50 mg in 5ml Injection
SUXAMETHONIUM100 mg in 2ml Injection

100 mg in 2ml Pre-Filled Syringe

Used in emergency / rushed procedures
BNF CODE – 15.1.6
ANTICHOLINESTERASES for reversal of NEUROMUSCULAR BLOCKADENOTES
NEOSTIGMINE2.5 mg in 1ml Injection
GLYCOPYRRONIUM BROMIDE  + NEOSTIGMINE500 microgram +2.5mg in 1ml AmpROBINUL – NEOSTIGMINEGeneral use – reversal NM block
OTHER DRUGS for reversal of NEUROMUSCULAR BLOCKADENOTES
SUGAMMADEX100mg/ml (2ml & 5ml ampoules)RESTRICTED Theatres/Anaesthetics
SMC Acceptance for Immediate Reversal
BNF CODE – 15.1.7
ANTAGONISTS FOR CENTRAL AND RESPIRATORY DEPRESSIONNOTES
FLUMAZENIL500 micrograms in 5ml InjectionReversal Benzodiazepines
NALOXONE400 micrograms in 1ml Injection

400 micrograms in 1ml MINIJET

40 micrograms in 2ml (NEONATAL)

Reversal OPIOIDS
BNF CODE – 15.1.8
ANTAGONISTS FOR MALIGNANT HYPERTHERMIANOTES
DANTROLENE SODIUM20 mg Intravenous InfusionReversal BZD
BNF CODE – 15.2.0
LOCAL ANAESTHESIANOTES
LIDOCAINENOTES
LIDOCAINE0.5 % Injection 20ml Vial

1 % Injection (10mg / ml)   5ml, 10ml Amp

2 % Injection (10mg / ml)   2ml, 5ml, 20ml Amp

LIDOCAINE
PREPARATIONS
LIDOCAINE   + ADRENALINE
/  EPINEPHRINE
0.5% +1:200,000

1% +1:100,000 5ml, 10ml amp

1% +1:200,000 20ml amp

2% + 1:200,000 20ml amp

2% +1:80,000 Dental Cartridges

LIDOCAINE + ADRENALINE PREPARATIONS
LIDOCAINE TOPICAL1 %, 2% Gel  15mlSURFACE & LOCAL ANAESTHESIA
LIDOCAINETOPICAL 4 % Solution  30mlSURFACE & LOCAL ANAESTHESIA

Unlicensed medicine

4th line anaesthetic treatment prior to endoscopy

LIDOCAINE4% Cream 5g Tube [LMX 4] TOPICAL RESTRICTED Paed.Anaesthetics / Paed.Day Case Only
SURFACE & LOCAL ANAESTHESIA
LIDOCAINE10% Oral Spray (10mg / dose)SURFACE & LOCAL ANAESTHESIA
LIDOCAINE + PRILOCAINE2.5% + 2.5% Cream 5g Tube [EMLA] TOPICALSURFACE & LOCAL ANAESTHESIA
LIDOCAINE  + PHENYLEPHRINE5% +0.5%
Topical Solution 2.5ml
SURFACE & LOCAL ANAESTHESIA
BUPIVICAINERESTRICTED TO ANAESTHETICS USE ONLY
BUPIVACAINE0.25%, 0.5% Polyamp 10mlMARCAIN POLYAMPS
BUPIVACAINE 5mg  Heavy 4ml Amp

250mL 0.125% Epidural Infusion

MARCAIN HEAVY Used for acute pain
BUPIVACAINE  & ADRENALINE0.25% & 1:200,000 Injection

0.5%  & 1:200,000 Injection

 

Long Term Supply Problem

LEVOBUPIVICAINEInjection 1.25mg/ml in 200ml bag

Injection 2.5mg/ml, 5mg/ml, 7.5 mg/ml vials

OTHER AGENTSNOTES
 Lidocaine 2%Optilube Active CHG free 11ml, 6mlOptilube Medicines Supply Issue Communication Updated Oct 20
‘MOFFAT’S’ 1% SOLUTIONCocaine 5% (2ml)+
Sodium Bicarbonate 1% (7ml) +
Adrenaline 1 in 1000 (1ml)
Pre-Packed Kit for reconstitution
RESTRICTED ENT Theatres Only
CITANEST 3% WITH OCTAPRESSIN0.03IU Standard Dental Cartridges
COCAINE5 % Solution

(Syringe) 25 % (1g in 1ml) Paste

CO-PHENYLCAINENozzle
ETHYL CHLORIDE50ml Spray
PRILOCAINE1 % Injection 50ml
PRILOCAINE20mg/ml (20%) 5ml amp
glucose 60mg/ml
PRILOTEKAL (hyperbaric)
RESTRICTED Use.
Consultant Anaesthetist
SMC (Prilotekal)
PROCAINE 2 % Injection
TETRACAINE 4 % (Amethocaine)
Ametop Gel

1. Gastro-Intestinal System | 2. Cardiovascular System | 3. Respiratory System | 4. Central Nervous System | 5. Antimicrobials | 6. Endocrine System | 7. Obstetrics, Gynaecology & Urology | 8. Malignant Disease & Immunosuppression | 9. Nutrition & Blood | 10. Musculoskelatal & Joint Diseases | 11. Opthalmology | 12. Ear, Nose & Oropharynx | 13. Dermatology | 14. Immunology & Vaccines | 15. Anaesthetics |  GP Centre Home