Polyethylene Glycol-Electrolyte Solution (PEG-ES)

A to Z Drug Facts

 Action Induces diarrhea, which rapidly cleanses bowel, usually within 4 hr.

 Indications Bowel cleansing prior to GI examination. Unlabeled use(s): Management of acute iron overdose in children.

 Contraindications GI obstruction; gastric retention; bowel perforation; toxic colitis; toxic megacolon or ileus.

 Route/Dosage

ADULTS: PO/Nasogastric 4 L prior to GI examination. Give orally as 240 ml q 10 min or via NG tube as 1.2 to 1.8 L/hr until 4 L are consumed or until rectal effluent is clear. Via nasogastric (NG) tube, use rate of 1.2 to 1.8 L/hr.

 Interactions

Oral medication given within 1 hr of starting therapy: Medication may be flushed from GI tract and not absorbed.

 Lab Test Interferences None well documented.

 Adverse Reactions

DERM: Urticaria; dermatitis. EENT: Rhinorrhea. GI: Nausea; abdominal fullness; bloating; abdominal cramps; vomiting; anal irritation.

 Precautions

Pregnancy: Category C. Children: Safety and efficacy not established. Regurgitation/Aspiration: Use with caution in patients with impaired gag reflex. Severe ulcerative colitis: Use with caution. If GI obstruction or perforation is suspected, rule out these contraindications before administration.

 Administration/Storage

• May be given via NG tube for patients unable or unwilling to drink solution.
• Reconstitute solution with tap water and shake container until powder is dissolved.
• Do not add flavorings or additional ingredients to solution before use. Chilling solution before administration improves palatability.
• Refrigerate reconstituted solution. Use within 48 hr.
• Administer minimum of 3 L of solution to achieve satisfactory bowel evacuation.

 Assessment/Interventions

• Obtain patient history, including drug history and any allergies. Note history of ulcerative colitis.
• Do not administer if patient has, or is suspected to have, GI obstruction, gastric retention, bowel perforation, toxic colitis, toxic megacolon, or ileus.
• Observe patients with impaired gag reflex or patient who is otherwise prone to regurgitation or aspiration during administration, especially if solution is given via NG tube.
• Notify physician if patient is unable to tolerate solution or if rectal bleeding occurs.
• If patient complains of bloating, abdominal pain or distention, slow solution or discontinue until symptoms abate.

 Patient/Family Education

• Explain that solution is given to cleanse bowel as preparation for GI examination.
• Explain that if discomfort becomes intolerable, patient should stop drinking solution temporarily or allow longer intervals between drink portions.
• Instruct patient not to eat or drink anything for 3 to 4 hr before ingestion and explain that only clear liquids are allowed after ingestion of solution.
• Tell patient to continue drinking solution until watery stool is clear and free of solid material.
• Instruct patient to report the following symptoms to physician: Severe bloating, distention, or abdominal pain.

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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts