you locate it in the BNFc?
What form does it come in?
What are the side effects?
Are there any interactions?
Can it be bought at the supermarket?
These are some considerations you may have to think about when supporting children, young people (CYP) and families with medication. Pharmaceutical reference guides will help you navigate this complex process and support your evidence‐based practice.
The British National Formulary and the British National Formulary for Children
Produced by the Joint Formulary Committee, the BNF is one of the most commonly used and reliable sources of information for medication with distinct versions for children and adults: the BNF and the BNF for children (BNFc).The Paediatric Formulary Committee (PFC) takes responsibility for the BNFc content. Ensuring that you use the most appropriate BNF for your practice area is essential as medications, recommendations, licensing, legislation and monitoring differ for adults and children. The BNF is published in paper copy bi‐annually in September and March and the BNFc is published in paper copy once a year in September. There are electronic versions (as discussed later) which are frequently updated, so it is always advisable to use the electronic version to ensure the most up‐to‐date information is accessed. This chapter focuses on the BNFc; the BNF follows the same layout but has additional and different information pertaining to medicines use for adults.
Practice Consideration
It is important that you use the correct version for your practice. The BNFc holds different and specific information in relation to medication and children. This is not the same as the BNF (which is for use in adults).
The BNFc is an essential tool for all practitioners working with children and young people, it is a repository of almost all drugs that are used in British health and social care settings, and offers comprehensive details on individual medications, groups of medications, uses, side effects and interactions and can assist with decision making. The information provided is sourced from summaries of product characteristics for medications, literature, consensus guidelines and peer review and employs a grading system of A–E and levels of evidence to help readers understand the strength of evidence underpinning the associated recommendations given (Joint Formulary Committee, 2019a).
Paper Copy BNFc
As a health professional you are accountable for using the most up‐to‐date evidence base for your practice. This means ensuring that you only use the current version of the BNFc which relates to your practice area and care of (CYP). The BNF also contains information on drugs licensed for use in children; however, the comprehensive literature relating more specifically to CYP will be found in the BNFc. A BNF will always be a good source for pharmaceutical information and can easily be used in the absence of a current BNFc, but should be used with caution.
You should consider:
That previous paper versions may have outdated information or even sections that have been removed
The implications of advising CYP and their families on medication regimens if the information source you have chosen is out of date. What are the potential risks to the CYP? What could this mean for your practice and accountability?
How to navigate the BNFc
At first glance the BNFc can be overwhelming; however, with a little practice it quickly becomes a fast and reliable way to gather information for yourself, patients and those you work with.
The current BNFc print versions are organised into four main sections:
Front matter
Chapters
Appendices
Back matterTable 2.1 Text format and information purpose.TEXT FORMATINFORMATION USEBlackInformation on treatment summary and therapeutic usesColour blockInformation on drug specific information
Careful attention should be paid to the font colour (see Table 2.1), images and symbols used in the BNF as these all convey pertinent information
Front Matter
The front matter of the BNFc gives quick access to information such as how to use the BNFc, the layout of information throughout chapters and significant changes that have taken place since the previous edition. General guidance is given on prescribing and the requirements of legal prescriptions, both handwritten and computer‐issued. Special attention is paid to controlled drugs, alongside adverse reactions to drugs and offers guidance on recognition and reporting.
A general overview of specific patient‐centred considerations is given in relation to prescribing in hepatic (liver) and renal (kidney) failure as well considerations for pregnancy, breast‐feeding and palliative care. Each section has a broad overview followed by specific considerations. For example, in prescribing for palliative care, specific information is provided on pain management, symptom control and continuous subcutaneous infusions.
Chapters
The main body of the BNFc is divided into systems chapters (i.e. gastrointestinal system) and follows the same structure.
Some drugs and chapters have a class monograph. A class monograph includes information that is common to all drugs within a particular class. It is important to read these in conjunction with the drug monograph which gives information relating to that drug in particular. Class monographs are identified by a flag in a circle
Access a copy of the current BNFc and open the gastrointestinal system chapter. It starts with a clear contents section indicating what can be found in the chapter on the gastrointestinal system and is followed by information on the associated diseases, conditions and disorders, treatment summaries and individual medication information. Focusing on constipation, find and read the description of the condition and its associated overview and management.
The classification of the individual drug is indicated in blue (e.g. Laxatives – Bulk‐forming Laxatives) with the drug name and drug monograph sited below. The drug monograph provides comprehensive information on the drug all in one concise section. Pertinent guidance is offered relating to drug action, indications and dose, adjustments and interactions, safety information, contraindications, signposting to the correct section of interactions, side effects and medicinal forms.
Drug‐class monographs
