Class: Hyperosmotic Laxative
Dosage Forms. Oral Powder for Solution: 236 g in 4-L container
Common FDA Label Indication, Dosing, and Titration.
1. Colonoscopy or barium enema preparation, 240 mL of reconstituted solution q10min until diarrhea is clear or 4 L are consumed or 20-30 mL/min via nasogastric tube until rectal effluent is clear or 4 L are administered
1. Fecal impaction, 500 mL bid (both doses taken within 4-6 h) × up to 3 d
MOA. Polyethylene glycol (PEG) electrolyte lavage solution is a hyperosmotic solution that includes various electrolytes (sodium sulfate, sodium bicarbonate, sodium chloride, potassium chloride). It is used for total bowel cleansing before gastrointestinal examinations, such as colonoscopy.
Drug Characteristics: Polyethylene Glycol
Medication Safety Issues: Polyethylene Glycol
Drug Interactions: Polyethylene Glycol
Adverse Reactions: Polyethylene Glycol
Efficacy Monitoring Parameters. Bowel movements should begin within 60 min of initiating administration, and dosing should continue until rectal effluent is clear.
Toxicity Monitoring Parameters. Seek medical attention if urticaria, rhinorrhea, or dermatitis occurs.
Key Patient Counseling Points. This preparation may cause nausea, anal irritation, or vomiting. If severe bloating, abdominal distension, or abdominal pain occurs, patient should slow the consumption of solution, and once symptoms have resolved, the patient may resume administration. Patient should not eat solid food for 3-4 h before beginning this treatment.
Clinical Pearls. Encourage patients to drink each portion rapidly, as this method is preferred over drinking small amounts continuously. The solution tastes better chilled, but ice should not be added to the solution. Since oral medications are flushed from their system by this treatment and may not be absorbed, patients should receive guidance from the prescriber of PEG solution regarding whether and when to take oral doses of other medications.