Macrogol / Polyethylene glycol
Bowel cleansing solutions contain **polyethylene glycol (macrogol)** as an osmotic laxative and balanced electrolytes to maintain isotonicity and prevent net fluid loss or gain. When administered orally, they rapidly empty the bowel. > **Clinical Pearl:** Commonly used for bowel preparation prior to colonoscopy, gastrointestinal radiography, or surgery, and occasionally for the management of severe refractory constipation or fecal impaction.
Mecanismo: **Polyethylene glycol** acts as an **osmotic laxative**. It is a large, non-absorbable polymer that binds water → retains fluid within the colonic lumen → increases fecal volume and softens stool → stimulates colonic motility and peristalsis → rapidly empties the bowel. The addition of balanced electrolytes ensures isotonicity, preventing significant shifts of sodium, potassium, or water across the intestinal mucosa.
Vías de administración
Contraindicaciones
- Gastrointestinal obstruction
- Bowel perforation
- Gastric retention
- Toxic megacolon
- Severe dehydration
Efectos adversos
- Nausea
- Vomiting
- Abdominal cramping
- Bloating
- Fluid and electrolyte imbalances (rare if formulated with electrolytes)
Interacciones farmacológicas
- Oral medications · Decreased absorption due to rapid gastrointestinal transit time · moderate
Monitoreo
- Fecal output and consistency
- Hydration status
- Serum electrolytes (in prolonged or high-dose use)
Sobredosis
Overdosage may result in severe diarrhea, leading to significant fluid and electrolyte loss. Treatment is primarily supportive, focusing on intravenous fluid therapy to restore hydration and correct any electrolyte derangements.
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