• Intermittent treatment of chronic constipation.

OsmoPrep:

• Cleansing of the bowel as a preparation for colonoscopy.

Contraindicated in:

• Hypersensitivity
• Abdominal pain, nausea, or vomiting, especially when associated with fever or other signs of an acute abdomen
• Severe renal or cardiovascular disease
• Intestinal obstruction
• OB: Not recommended for use at term
• OsmoPrep: HF, ascites, unstable angina, acute colitis, toxic megacolon, or hypomotility syndrome
• Pedi: Children <2 yr.

Use Cautiously in:

• Excessive or chronic use (may lead to dependence)
• Renal or cardiovascular disease, dehydration or concurrent use of diuretics or other drugs known to alter electrolytes (correct abnormalities prior to administration)
• Dehydration, renal dysfunction, bowel obstruction, active colitis, or concurrent use of diuretics, ACE inhibitors, ARBs, or NSAIDs (↑ risk of acute phosphate nephropathy)
• OB: May cause sodium retention and edema
• Geri: May be more sensitive to effects.

CV: ARRHYTHMIAS.

GI: cramping, nausea, colonic aphtous ulcerations, ischemic colitis.
OsmoPrep: abdominal bloating, abdominal pain, vomiting.

F and E: hyperphosphatemia, hypocalcemia, hypokalemia, sodium retention.

GU: renal dysfunction.

Neuro: Visicol: dizziness, headache.

Drug-Drug:

• OsmoPrep: Concurrently administered oral medications may not be absorbed due to rapid peristalsis and diarrhea.

(Generic available)

• Oral solution: 0.9 g dibasic sodium phosphate and 2.4 g monobasic sodium biphosphate/5 mL;
• Enema: 7 g dibasic sodium phosphate and 19 g monobasic sodium biphosphate/118 mL;
• Tablets (OsmoPrep): 1.5 g;

Bowel Cleansing

• PO (Adults): OsmoPrep: evening before colonoscopy: 4 tablets every 15 min (with at least 8 oz of water) for a total of 20 tablets; on morning of colonoscopy starting 3–5 hr before procedure, 4 tablets every 15 min (with at least 8 oz of clear liquids), for a total of 12 tablets; should not be repeated in less than 7 days.

Constipation

• PO (Adults): 15 mL as single dose.
• PO (Children 5–9 yr): 7.5 mL as single dose.
• Rect (Adults and Children >12 yr): 118 mL Fleet Enema.
• Rect (Children >2 yr): ½ of the adult dose.

Fleet Enema, OsmoPrep

• Osmotically active in the lumen of the GI tract.
• Produces laxative effect by causing water retention and stimulation of peristalsis.
• Stimulates motility and inhibits fluid and electrolyte absorption from the small intestine.

• Relief of constipation.
• Emptying of the bowel.

Therapeutic Classification: laxatives (saline)

Absorption: 1–20% of rectally administered sodium and phosphate may be absorbed; some absorption follows oral administration.

Distribution: Unknown.

Metabolism/Excretion: Excreted by the kidneys.

Half-life: Unknown.

(laxative effect)

• Advise patient that laxatives should be used only for short-term therapy. Avoid using more than 1 dose of OTC laxatives/day. Long-term therapy may cause electrolyte imbalance and dependence.
• Caution patient on sodium restriction that this product has a high sodium content.
• Advise patient not to take oral form of this medication within 2 hr of other medications.
• Encourage patient to use other forms of bowel regulation, such as increasing bulk in the diet, fluid intake, and mobility. Normal bowel habits may vary from 3 times/day to 3 times/wk.
• Advise patient to notify health care professional if unrelieved constipation, rectal bleeding, or symptoms of electrolyte imbalance (muscle cramps or pain, weakness, dizziness, and so forth) occur.

FOSS-fate/bye-FOSS -fate