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Extra resources for British National Formulary 61
18 Prescribing in renal impairment Prescribing in renal impairment Renal function is measured either in terms of estimated glomerular filtration rate (eGFR) calculated from a formula derived from the Modification of Diet in Renal Disease study (‘MDRD formula’ that uses serum creatinine, age, sex, and race (for Afro-Caribbean patients)) or it can be expressed as creatinine clearance (best derived from a 24-hour urine collection but often calculated from the Cockcroft and Gault formula (CG). BNF 61 In the BNF, values for eGFR, creatinine clearance (for toxic drugs), or another measure of renal function are included where possible.
There is no standard time for which products retain a black triangle; safety data are usually reviewed after 2 years. Spontaneous reporting is particularly valuable for recognising possible new hazards rapidly. For medicines showing the black triangle symbol, the MHRA asks that all suspected reactions (including those considered not to be serious) are reported through the Yellow Card Scheme. An adverse reaction should be reported even if it is not certain that the drug has caused it, or if the reaction is well recognised, or if other drugs have been given at the same time.
1). 2). 2 Insomnia Patients with advanced cancer may not sleep because of discomfort, cramps, night sweats, joint stiffness, or fear. There should be appropriate treatment of these problems before hypnotics are used. 1), may be useful. Intractable cough Intractable cough may be relieved by moist inhalations or by regular administration of oral morphine in an initial dose of 5 mg every 4 hours. 1. m. to reduce the risk of insomnia. Restlessness and confusion Restlessness and confusion may require treatment with haloperidol 1–3 mg by mouth every 8 hours.
British National Formulary 61 by Bma