No

Cathartic; Laxative, Bowel Evacuant

Bowel cleansing prior to GI examination or following toxic ingestion

C

Gastrointestinal obstruction, gastric retention, bowel perforation, toxic colitis, megacolon

Safety and efficacy not established in children; do not add flavorings as additional ingredients before use; observe unconscious or semiconscious patients with impaired gag reflex or those who are otherwise prone to regurgitation or aspiration during administration; use with caution in ulcerative colitis, caution against the use of hot loop polypectomy

>10%: Gastrointestinal: Nausea, abdominal fullness, bloating

1% to 10%: Gastrointestinal: Abdominal cramps, vomiting, anal irritation

<1%: Rash

Oral medications should not be administered within 1 hour of start of therapy

Use within 48 hours of preparation; refrigerate reconstituted solution; tap water may be used for preparation of the solution; shake container vigorously several times to ensure dissolution of powder

Induces catharsis by strong electrolyte and osmotic effects

Onset of effect: Oral: Within 1-2 hours

The recommended dose for adults is 4 L of solution prior to gastrointestinal examination, as ingestion of this dose produces a satisfactory preparation in >95% of patients. Ideally the patient should fast for approximately 3-4 hours prior to administration, but in no case should solid food be given for at least 2 hours before the solution is given. The solution is usually administered orally, but may be given via nasogastric tube to patients who are unwilling or unable to drink the solution.

Adults:

Oral: At a rate of 240 mL (8 oz) every 10 minutes, until 4 liters are consumed or the rectal effluent is clear; rapid drinking of each portion is preferred to drinking small amounts continuously

Nasogastric tube: At a rate of 20-30 mL/minute (1.2-1.8 L/hour); the first bowel movement should occur approximately 1 hour after the start of administration

Ideally the patient should fast for approximately 3-4 hours prior to administration, but in no case should solid food be given for at least 2 hours before the solution is given

Electrolytes, serum glucose, BUN, urine osmolality

No information available to require special precautions

No effects or complications reported

Chilled solution is often more palatable. Produces a watery stool which cleanses the bowel before examination. Prepare solution according to instructions on the bottle. For best results, no solid food should be consumed during the 3- to 4-hour period before drinking solution, but in no case should solid foods be eaten within 2 hours of taking. Drink 240 mL every 10 minutes. Rapid drinking of each portion is better than drinking small amounts continuously. The first bowel movement should occur approximately 1 hour after the start of administration. May experience some abdominal bloating and distention before bowel starts to move. If severe discomfort or distention occurs, stop drinking temporarily or drink each portion at longer intervals until these symptoms disappear. Continue drinking until the watery stool is clear and free of solid matter. This usually requires at least 3 L. It is best to drink all of the solutions. Discard any unused portion. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to be pregnant. Consult prescriber if breast-feeding.

Rapid drinking of each portion is preferred over small amounts continuously; first bowel movement should occur in 1 hour; chilled solution often more palatable; do not add flavorings as additional ingredients before use

Powder, for oral solution: PEG 3350 236 g, sodium sulfate 22.74 g, sodium bicarbonate 6.74 g, sodium chloride 5.86 g and potassium chloride 2.97 g (2000 mL, 4000 mL, 4800 mL, 6000 mL)

Harris CR and Kingston R, "Gastrointestinal Decontamination, Which Method Is Best?" Postgrad Med, 1992, 92(2):116-22, 125, 128.

Olsen KM, Gurley BJ, Davis GA, et al, "Comparison of Fluid Volumes With Whole Bowel Irrigation in a Simulated Overdose of Ibuprofen," Ann Pharmacother, 1995, 29(3):246-50.

Porter RS and Baker EB, "Drug Clearance by Diarrhea Induction," Am J Emerg Med, 1985, 3(3):182-6.

Scharman EJ, Lembersky R, and Krenzelok EP, "Efficiency of Whole Bowel Irrigation With and Without Metoclopramide Pretreatment," Am J Emerg Med, 1994, 12(3):302-5.

Sondheimer JM, Sokol RJ, Taylor SF, et al, "Safety, Efficacy and Tolerance of Intestinal Lavage in Pediatric Patients Undergoing Diagnostic Colonoscopy," J Pediatr, 1991, 119(1):148-52.

Tuggle DW, Hoelzer DJ, Tunell WP, et al, "The Safety and Cost-Effectiveness of Polyethylene Glycol Electrolyte Solution Bowel: Preparation in Infants and Children," J Pediatr Surg, 1987, 22(6):513-5.