On-call scenario 8: Sources
Information sources that you might have thought about looking in, include:- Your pharmacy stock control system
- BNF for Children
- SmPCs via the emc or MHRA
- Evelina London Paediatric Formulary (formerly Guy’s Paediatric Formulary)
- Drug Administration via Enteral Feeding Tubes
- NEWT Guidelines
A check of these information resources reveals that there is a ready-made azathioprine suspension available to buy, but your hospital pharmacy has none in stock. Crushing azathioprine tablets may pose a risk to the mother and the child. The risk to the mother comes from the cytotoxic dust that may be produced when crushing the tablets. The risk to the child from administration in this way arises because the tablet may not be fully dispersed/dissolved; this might mean that he is either under- or over-dosed, both of which could have serious consequences.
Now that you've more information, how can you advise the nurse?
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