colonoscopy prep Flashcards
what are the types of bowel preps
isosmotic
hyper-osmotic
stimulant laxatives
What is isosmotic prep
no permeation of cell membranes
these are PEG (polyethylene glycol) - based electroylet lavage solutions
negligible absorption from GI tract
what is the MOA for PEG
osmotic effect of PEG causes water to be trained in colon - produces watery stool
no significant changes in water or electrolyte balance occur
what are the full volume isosmotic preps
colyte
GoLYTELY
NuLYTELY
TriLyte
what are the low volume preps
HalfLytely
Miralax
MoviPrep
what are the advantages of PEG-based preps
no mucosal damage
minimal osmotic fluid shifts
safer than sodium phosphate-based solutions in patients with impaired renal function, CHF, cirrhosis or baseline elecytrolyte abnormalities
what are the disadvantages of PEG-based preps
large volume of fluid (4L)
unpalatable taste (if not flavored)
what are contraindications of PEG-based solution
patients with gastric outlet obstruction
high-grade small bowel obstruction
suspected bowel perforation
how often is PEG-based solutions taken
240ml (8oz) every 10 minutes
what is a hyperosmotic prep
contains a higher concentration of salts or other dissolved material than normal tissues
what is the MOA of hyperosmotic preps
increase intraluminal water (pulls water into intestine) by promoting passage of extracellular fluid across the bowel wall
high Na+ concentration - causes watery diarrhea
what is the main formulation of hyperosmotic preps
sodium phosphate
what are the hyperosmotic preps
OsmoPrep
Suprp
Prepopik
Clinpiq
what is the first FDA approved ready to drink low volume bowel prep
clenpiq
what is the MOA of clinpiq
prodrug, has no significatn direct physiological effect on the intestine
metabolized by gut bacteria into active compound 4,4’-dihydroxydiphenyl-(2-pyridiyl) methane (DPM, DPHM)