Constipation and bowel cleansers:
Indications for GoLYTELY:
Bowel cleansing before colonscopy and barium enema x-ray examination.
May consume water or clear liquids during and after completion of bowel prep up until 2hrs before procedure. Drink 240mL orally every 10 mins or 20–30mL/min by NG tube until rectal effluent is clear or 1 gallon consumed. May interrupt if severe GI disturbances occur.
GI obstruction. Bowel perforation. Gastric retention. Ileus. Toxic colitis or megacolon.
Not for direct ingestion. Correct fluid/electrolyte abnormalities before use. History of prolonged QT, uncontrolled arrhythmias, recent MI, unstable angina, CHF, or cardiomyopathy: increased risk of arrhythmias; consider ECGs at pre-dose and post-colonoscopy. History or risk of seizures. Renal impairment: monitor baseline and post-colonoscopy electrolytes, creatinine, BUN. Inflammatory bowel disease. Rule out suspected GI obstruction/perforation before administering. Severe ulcerative colitis. Impaired gag reflex. Semi- or unconscious patients. Risk of regurgitation or aspiration. Maintain adequate hydration. Pregnancy. Nursing mothers.
Isosmotic bowel cleanser.
Caution with drugs that increase risk of fluid/electrolyte abnormalities, arrhythmias or QT prolongation. Drugs that may lower the seizure threshold (eg, tricyclic antidepressants), alcohol or benzodiazepine withdrawal, known or suspected hyponatremia: may increase risk of seizures. Concomitant diuretics, ACE inhibitors, ARBs, NSAIDs; may affect renal function. Avoid concomitant stimulant laxatives (eg, bisacodyl, sodium picosulfate). Oral drugs administered within 1hr of start of Golytely may not be absorbed.
Nausea, abdominal fullness, bloating, cramps, vomiting, anal irritation; seizures, arrhythmias, mucosal ulcerations and ischemic colitis, hypersensitivity reactions.
Disposable jug (4L)—1