Poly ethylene Glycol 3350 + Electrolytes
Indications
Poly ethylene Glycol 3350 + Electrolytes is used for:
For effective relief from, constipation, treatment of chronic constipation, Resolving fecal impaction.
Adult Dose
Adults
Constipation: 25 ml of oral solution added to 100 ml of water once daily (to make a total volume of 125 ml). This may be increased to 2-3 doses of 25 ml daily (each 25 ml dose added to 100 ml of water), if required according to individual response.
Fecal Impaction: 8 doses of 25 ml daily (each 25 ml dose added to 100 ml of water). A course of treatment for fecal impaction does not normally exceed 3 days.
Child Dose
Child> 12 years:
Constipation: 25 ml of oral solution added to 100 ml of water once daily (to make a total volume of 125 ml). This may be increased to 2-3 doses of 25 ml daily (each 25 ml dose added to 100 ml of water), if required according to individual response.
Fecal Impaction: 8 doses of 25 ml daily (each 25 ml dose added to 100 ml of water). A course of treatment for fecal impaction does not normally exceed 3 days.
Renal Dose
Administration
Measure 25 ml of oral solution with the 25 ml measuring cup provided, then add this to 100 ml of water. Any unused diluted solution should be discarded within 24 hours.
Contra Indications
Polyethylene glycol is contraindicated in patients with known or suspected bowel obstruction and patients known to be allergic to polyethylene glycol.
Precautions
Patients with impaired cardiovascular function: For the treatment of faecal impaction the dose should be divided so that no more than two sachets are taken in any one hour. If patients develop any symptoms indicating shifts of fluid/electrolytes (e.g. edema, shortness of breath, increasing fatigue, dehydration, cardiac failure) It should be stopped immediately and any abnormality should be treated appropriately. Prolonged use with all laxatives is undesirable and may lead to dependence.
Patients with symptoms suggestive of bowel obstruction (nausea, vomiting, abdominal pain or distention) should be evaluated to rule out this condition before initiating.
There is no experience of the use of Polyethylene Glycol 3350 during pregnancy and lactation. It should only be used if considered essential by the physician.
Pregnancy-Lactation
Pregnancy category: C
Lactation: No data available
Interactions
Adverse Effects
Side effects of Poly ethylene Glycol 3350 + Electrolytes :
Electrolyte disturbances particularly hyperkalaemia and hypokalaemia, abdominal pain, diarrhoea, headache, peripheral edema may appear. Nausea, abdominal bloating, cramping and flatulence may occur. High doses may produce diarrhea and excessive stool frequency, particularly in elderly nursing home patients. Patients taking other medications containing polyethylene glycol have occasionally developed urticaria suggestive of an allergic reaction.
Mechanism of Action
Polyethylene Glycol 3350 exerts an osmotic action in the gut, which induces a laxative effect. Polyethylene Glycol 3350 increases the stool volume, which triggers colon motility via neuromuscular pathways. Electrolytes combined with Polyethylene Glycol 3350 are exchanged across the intestinal barrier (mucosa) with serum electrolytes and excreted in fecal water without net gain or loss of sodium, potassium and water.
Sodium chloride is the major extracellular cation. It is important in electrolyte and fluid balance, osmotic pressure control and water distribution as it restores sodium ions. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis and treatment of hyperosmolar diabetes. It is also used as diluents for infusion of compatible drug additives. Potassium chloride is a major cation of the intracellular fluid. It plays an active role in the conduction of nerve impulses in the heart, brain and skeletal muscle; contraction of cardiac skeletal and smooth muscles; maintenance of normal renal function, acid-base balance, carbohydrate metabolism and gastric secretion. Sodium bicarbonate raises blood and urinary pH by dissociation to provide bicarbonate ions, which neutralises the hydrogen ion concentration. It also neutralises gastric acid via production of carbon dioxide.