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Advanced Pediatrics Gastroenterology, PC
DAY OF PROCEDURE : Please arrive in the REGISTRATION area at
CHANDLER REGIONAL HOSPITAL
DR SANJEEV KHURANA, MD, FAAP
PRIOR TO PROCEDURE:
YO U WILL NEED TO PURCHASE:
• GLYCOLAX 255g Powder (Prescription Required)
• 4 DULCOLAX (bisacodyl) LAXATIVE TABLETS (Available over the counter)
• 1 Bottles of 64 ounces of GATORADE (NO RED, BLUE OR PURPLE)
• Diaper Rash Cream-optional
MEDICATIONS: In general, all medications should be continued in routine dosage
EXCEPT medications that will affect blood clotting. If you are on any sort of blood
clotting medication, your physician should approve you stopping the medicine. The
following are the drugs that will require some individualized instructions:
1 DAY BEFORE PROCEDURE
Begin a clear liquid diet in the morning by drinking the 1st bottle of Gatorade (64
CLEAR LIQUID DIET
Any Clear fruit juice, WITHOUT PULP, soft drinks, clear broth, (beef or
chicken bouillon is fine), coffee, tea, Kool-aid, Gatorade, Jello, Gelatin, and
regular Popsicles, any type of hard candy, but no soft centers or chocolate.
No Milk or dairy products. NOTHING WITH RED, BLUE OR PURPLE
Between 4-6 pm take 2 DULCOLAX (bisacodyl) LAXATIVE TABLETS
water or Gatorade. Swallow whole-do not chew or crush. You should have a
bowel movement within 1-2 hours. Diaper rash cream can be applied to your
rectal area to decrease irritation.
Mix the entire container of GLYCOLAX POWDER
into the 2nd Bottle of
Gatorade (64 ounce)-it should completely dissolve. Chill in the refrigerator.
Start drinking this liquid after you have a bowel movement or within 2 hours of
taking the Dulcolax-whichever comes first. Drink 8 oz every 10 to 20 minutes
over a period of 1-2 hours until you drink the entire container. If you get chills or
feel bloated, slow down and drink some warm clear liquids.
you are passing clear bowel movements, you are finished. IF
movements are not clear, take 2 more DULCOLAX (bisacodyl) LAXATIVE
TABLETS with water.
Nothing to eat or drink after midnight except small sips of water with your morning medications. Exceptions are listed on page 1.
• This exam is most successful if these instructions are followed exactly as stated.
• If you use a CPAP machine at night for sleep apnea, please bring this with you.
• Bring a list of your current medications (including dosages with you).
• Verify any questions about co-pays with your insurance.
***If you have to cancel your exam, please contact us at least 72 hours (3 business days) in
as a courtesy to other patients and your physician.
PLEASE CALL ME DIRECTLY IF YOU HAVE ANY QUESTIONS AT 480-857-2307 5/8/2007
YOU WILL BE AT THE HOSPITAL
FOR APPROXIMATELY 2-4 HOURS.
Please fax back back to: 713-973-0805 DESTINATION ( Required ): _____________________ Length of Stay: Departure Date : _______ _____________________ MEDICATION/KIT/SUPPLY REQUESTED: MED KIT: ______Basic _____Full * Hydrocodone/Acetaminophen 5/500 Cost Center/PO/SAP# ( Global Santa Fe Employees must indicate Cost Center & SAP #)
COLOMBIANA DE SALUD S.A. MANUAL DE CALIDAD GUIAS DE MANEJO Y Página 1 de 21 CDS-GDM 2.2.1-03 DIAGNOSTICO ODONTOLOGICO EN Revisión 02 Junio 2012 ENDODONCIA No de Revisión Elaboró COLOMBIANA DE SALUD S.A. MANUAL DE CALIDAD GUIAS DE MANEJO Y Página 2 de 21 CDS-GDM 2.2.1-03 DIAGNOSTICO ODONTOLOGICO EN Revisión 02