Shaping better health
REMEDY : BNSSG referral pathways & Joint Formulary

BNSSG Paediatric Joint Formulary

10.2 Neuromuscular disorders

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First line drugs Second line drugs Specialist drugs Secondary care drugs

 

10.2.1 Myasthenia gravis

Anticholinesterases

Neostigmine (TLS Red)

  • Only on the recommendation of a Consultant Neurologist

Pyridostigmine (TLS Red)

  • Only on the recommendation of a Consultant Neurologist

 

10.2.2 Spasticity Baclofen

Gamma-aminobutyric Acid Analogues and Derivatives

Baclofen (intrathecal) (TLS Red)

  • Baclofen may lead to reversible neurological changes and coma in people with low kidney function. Start at very low doses at very long intervals in these patients and titrate to effect
  • Refer to the NHS England Policy D04/P/c: Intrathecal baclofen (ITB)
  • For Intrathecal baclofen use please refer to the BNSSG Prior Approval Form - Continuous Intrathecal Baclofen Infusion.  This needs to be completed and approved prior to initiation