Diabasic Sodium Phosphate + Monobasic Sodium Phosphate
Indications
Diabasic Sodium Phosphate + Monobasic Sodium Phosphate is used for:
Cleansing of the colon
Adult Dose
Oral
Tablets are indicated for cleansing of the colon as a preparation for colonoscopy in adults 18 years of age or older.
Evening before the colonoscopy: Four tablets with 8 ounces (oz.) of clear liquids every 15 minutes (for a total of 20 tablets).
Day of colonoscopy (starting 3 to 5 hours before the procedure): Four tablets with 8 oz. of clear liquids every 15 minutes (for a total of 12 tablets).
As Rectal Enema
Constipation & Bowel Cleansing
1 bottle PR; not to exceed 1 administration/24 hr
Child Dose
As Rectal Enema
Constipation & Bowel Cleansing
Indicated as laxative in the relief of occasional constipation and as part of a bowel cleansing regimen in preparing the colon for surgery, x-ray or endoscopic examination
<2 years: Do not use
2-4 years: Administer one-half bottle PR of pediatric enema (ie, ~30 mL); prepare dose by unscrewing cap from bottle and removing 2 tablespoons of liquid (30 mL) with a measuring spoon, replace cap and administer remaining liquid
5-11 years: Administer 1 bottle PR of pediatric enema (ie, 59 mL)
12 years or older: Administer as in adults (adult enema)
Renal Dose
Use with caution
Administration
Remove orange protective shield from enema tip before inserting; with steady pressure, gently insert enema tip into rectum with a slight side-to-side movement, with tip pointing toward navel
Insertion may be easier if person receiving enema bears down, as if having a bowel movement; this helps relax the muscles around the anus
Do not force enema tip into rectum as this can cause injury
Squeeze bottle until nearly all liquid is gone; it is not necessary to empty the bottle completely, as it contains more liquid than needed
Remove enema tip from rectum and maintain position until urge to evacuate is strong (usually 1-5 minutes)
Do not retain enema solution for more than 10 minutes
Positions for using this enema
Left-side position: Lie on left side with knee bent, and arms resting comfortably
Knee-chest position: Kneel, and then lower head and chest forward until left side of face is resting on surface with left arm folded comfortably
Contra Indications
Sodium Phosphates is contraindicated in diseases where high sodium, high phosphorus or low calcium levels may be encountered. Known allergy or hypersensitivity to sodium phosphate salts or any component
Biopsy-proven acute phosphate nephropathy, Gastrointestinal (GI) obstruction, Gastric bypass or stapling surgery, Bowel perforation, Toxic colitis, Toxic megacolon.
Precautions
Phosphorus replacement therapy with sodium phosphates should be guided primarily by the serum inorganic phosphorus levels and the limits imposed by the accompanying sodium (Na+) ion. Frequent monitoring of serum calcium and sodium as well as renal function is recommended.
Use with caution in patients with renal impairment, cirrhosis, cardiac failure or in conjunction with other edema causing medications. It should not be used with sodium retaining medications.
Caution must be exercised in the administration of parenteral fluids especially those containing sodium ion, to patients receiving corticosteroids or corticotropin.
Lactation: Unknown whether distributed in breast milk; caution because of risk for electrolyte disturbances or dehydration
Pregnancy-Lactation
Pregnancy Category: C
Lactation: Unknown whether distributed in breast milk; caution because of risk for electrolyte disturbances or dehydration
Interactions
Adverse Effects
Side effects of Diabasic Sodium Phosphate + Monobasic Sodium Phosphate :
Hypersensitivity, Pruritus, Dehydration, Hyperphosphatemia, Hypocalcemia, Hypokalemia, Hypernatremia, Metabolic acidosis, Nausea, Vomiting, Abdominal pain, Abdominal distension, Diarrhea, Gastrointestinal pain, Chills, Blistering, Stinging, Anal discomfort, Proctalgia
Mechanism of Action
Saline cathartic effect. Draws water into the lumen of the gut where it causes osmotic effect; causes abdominal distention and promotes peristalsis and evacuation of the bowel.