GoLYTELY


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GoLYTELY

 [go-līt´le]
trademark for a preparation of polyethylene glycol-3350 and the electrolytes sodium sulfate, sodium bicarbonate, sodium chloride, and potassium chloride; administered orally in an aqueous solution as a gentle cathartic prior to studies that require bowel preparation.

polyethylene glycol/electrolyte

(po-lee-eth-e-leen glye-kole/e-lek-troe-lite) ,

Colyte

(trade name),

GoLYTELY

(trade name),

Klean-Prep

(trade name),

MoviPrep

(trade name),

NuLytely

(trade name),

Suclear

(trade name),

TriLyte

(trade name)

Classification

Therapeutic: laxatives
Pharmacologic: osmotics
Pregnancy Category: C

Indications

Bowel cleansing in preparation for GI examination.Treatment of acute iron overdose in children.

Action

Polyethylene glycol (PEG) in solution acts as an osmotic agent, drawing water into the lumen of the GI tract.

Therapeutic effects

Evacuation of the GI tract without water or electrolyte imbalance.

Pharmacokinetics

Absorption: Ions in the solution are nonabsorbable.
Distribution: Unknown.
Metabolism and Excretion: Solution is excreted in fecal contents.
Half-life: Unknown.

Time/action profile

ROUTEONSETPEAKDURATION
PO1 hrunknown4 hr

Contraindications/Precautions

Contraindicated in: GI obstruction;Bowel perforationGastric retention;Toxic colitis;Toxic megacolon.
Use Cautiously in: Patients with absent or diminished gag reflex;Unconscious or semicomatose states, in which administration is via NG tube;History of ulcerative colitis (↑ risk of hypoglycemia, dehydration, and hypokalemia);Barium enema using double-contrast technique (may not allow proper barium coating of mucosa);Seizure disordersAbdominal pain of uncertain cause, particularly if accompanied by fever; Geriatric: May be more sensitive to effects; Pediatric: Children (safety not established; children <2 yr more prone to hypoglycemia, dehydration, and hypokalemia).

Adverse Reactions/Side Effects

Gastrointestinal

  • abdominal fullness (most frequent)
  • diarrhea (most frequent)
  • bloating
  • cramps
  • ischemic colitis
  • nausea
  • vomiting

Fluid and Electrolyte

  • fluid and electrolyte abnormalities

Miscellaneous

  • allergic reactions (rare)

Interactions

Drug-Drug interaction

Interferes with the absorption of orally administered medications by decreasing transit time (do not administer within 1 hr of start of therapy).

Route/Dosage

Oral (Adults) 240 mL q 10 min (up to 4 L) until fecal discharge appears clear and has no solid material; may be given through NG tube at 20–30 mL/min (up to 4 L); Moviprep—On evening before colonoscopy, give 240 mL q 15 min for 1 hr followed by 480 mL of clear liquid before going to bed; on morning of colonoscopy, give 240 mL q 15 min for 1 hr, followed by 480 mL of clear liquid at least 2 hr before test (alternative regimen is 240 mL q 15 min for 1 hr at least 3 hr before bedtime on evening before colonscopy, then 1.5 hr later, give 240 mL q 15 min for 1 hr; may drink clear fluids up to 2 hr before test); Suclear—On evening before colonoscopy, dilute 6–oz oral solution by pouring entire contents into 16–oz mixing container and then filling container with cool water to fill line. Drink entire container within 20 min. Refill container with 480 mL of water and drink over next 2 hr. Refill container with 480 mL of water and finish drinking before going to bed. On morning of colonoscopy (≥3.5 hr before exam), dissolve powder of Dose 2 by adding water to fill line. Drink 480 mL every 20 min completing the dose ≥2 hr before test.
Oral (Children ≥6 mo) 25 mL/kg/hr until fecal discharge is clear and has no solid material; may also be given through an NG tube (unlabeled).

Availability (generic available)

Powder for oral solutionregular, pineapple, citrus berry, lemon lime, orange, cherry flavor: CoLyte, NuLytely, TriLyte—powder in bottles for reconstitution, GoLYTLEY—powder in packets and bottles for reconstitution, MoviPrep—powder in pouches for reconstitution, Suclear—oral solution in bottle and powder for reconstitution in bottle

Nursing implications

Nursing assessment

  • Assess color, consistency, and amount of stool produced.
  • Monitor semiconscious or unconscious patients closely for regurgitation when administering via NG tube.

Potential Nursing Diagnoses

Diarrhea (Side Effects)

Implementation

  • Do not add extra flavorings or additional ingredients to solution prior to administration.
    • Avoid solid food and milk within 1–2 hr of administration, but should be adequately hydrated prior to, during, and after administration.
    • Patient should be allowed only clear liquids after administration.
    • May be administered on the morning of the examination as long as time is allotted to drink solution (3 hr) and evacuate bowel (1 additional hr). For barium enema, administer solution early evening (6 pm) prior to exam to allow proper mucosal coating by barium.
  • Oral: Solution may be reconstituted with tap water. Shake vigorously until powder is dissolved.
    • Follow 2 dose regimen for Suclear™.
    • May be administered via NG tube at a rate of 20–30 mL/min.

Patient/Family Teaching

  • Instruct patient to drink 240 mL every 10 min until 4 L have been consumed or fecal discharge is clear and free of solid matter. Rapidly drinking each 240 mL is preferred over drinking small amounts continuously.
  • Advise patient to avoid alcohol during prep.

Evaluation/Desired Outcomes

  • Diarrhea, which cleanses the bowel within 4 hr. The first bowel movement usually occurs within 1 hr of administration.
References in periodicals archive ?
GoLytely is one of the safest and most frequently used bowel preparation regimens available, but the large volume (4 L) that patients must drink in a relatively short time, as well as the unpleasant taste attributed to the electrolytes it contains, can make it difficult to tolerate, the authors wrote.
Hjelkrem and his colleagues assessed GoLytely and MiraLAX in a 1year study in which 425 patients undergoing screening colonoscopy were randomly assigned to bowel prep with GoLytely alone, MiraLAX alone, MiraLAX plus lubiprostone pretreatment, or MiraLAX plus bisacodyl pretreatment.
GoLytely was more effective for overall bowel cleansing and for cleansing of the ascending, transverse, and descending colon, as measured by the OBPS score.
Mylan received final approval for its abbreviated new drug application for polyethylene glycol 3350 and electrolytes for oral solution, a generic version of Braintree Laboratories' GoLytely laxative.
8 g/kg/day PO (PEG, MiraLax) Max: 17 g/day (1 tablespoon) Disimpaction: 25 mL/kg/hr Max: 1,000 mL/hr GoLytely 25-40 mL/kg/h PO until rectal effluent clear Max: 4 liters Stimulant Senna (Senokot, Children 10-20 mg/kg/dose Exlax, Fletcher's 2-6 y.
The process of instilling and then flushing large volumes of irrigation solutions such as Colyte or Golytely is "unbelievably messy and labor-intensive," he said.
The standard bowel preparation in this study group was Golytely (Braintree Laboratories, Inc, Braintree, Mass), which allowed for adequate examinations.
Later in the study, the authors preferentially started using a balanced electrolyte purge solution such as Golytely (Braintree Laboratories, Braintree, Mass) or Colyte (Reed and Carnick, Piscataway, NJ).