SEATTLE UROLOGICAL ASSOCIATES     206.292.6488

 

BOWEL PREP FOR SURGICAL PROCEDURES WITH ANTIBIOTICS

 

Although small, the risk of infection with abdominal surgery is real. In order to reduce the risk of infection you will be on a special bowel preparation program.

 

TWO DAYS BEFORE SURGERY.............  DAY:  ___________________________

 

                                      DATE: _________/_________/_______

 

Take your regular medications (except aspirin or aspirin products), unless otherwise informed.   You may have a regular breakfast and a light lunch.   After lunch between 1 and 3 PM you should take ONE of the following laxatives.....

 

[  ]  8 ounces of Magnesium Citrate        (Use unless other specified)

 

[ ] 3 Dulcolax tablets

 

[ ] 3 tablespoons of Milk of Magnesia

 

[ ] 2 ounces of castor oil

 

[ ] One bottle Fleets Phospha Soda

 

NOTE:   EXPECT DIARRHEA FROM ANY OF THESE LAXATIVES

 

After lunch you must limit your diet to clear liquids. This is most important!! NO SOLID FOODS, NO MILK OR DAIRY PRODUCTS...please!

 

We recommend a glass of juice, tea, coffee, soda pop or water every hour.  You should push the fluids as much as possible.

 

-------------------------------------------------------------------------------------------------------------------------------

 

THE DAY BEFORE SURGERY............. DAY:  ________________________________

DATE: __________/___________/_________

 

You must stay on the clear liquids.  At 10 AM you should take the following oral antibiotics:

------   Neomycin  1 Gram

------   Erythromycin Base 1 Gram

 

These drugs should be repeated at 1 PM.  The drugs can be obtained from the pharmacy at the hospital as most local drug stores will not carry them.

 

Unless otherwise notified, you will have no food or liquids after midnight before your procedure.

 

Thank you for your help

 

Remember -- no Aspirin products 7-10 days before surgery!!!!!!

 


 

               Patient Name ___________________________________

 

              Patient Address __________________________________

 

                                                                                                    Date:_______________

NOTE:

This prescription needs to filled out and signed by your doctor.

 

 

Seattle  Urological Associates

1221 Madison Street   Suite #1210      Seattle, Washington  98104-1360

Tel: (206) 292-6488     Fax: (206) 623-2436

 

Rx

 

 

Neomycin Tablets  500 mg  #4

 

On the day before the surgery take

Two tablets at 10 am and  1:00 pm

 

 

 

Erythromycin Base  500 mg  #4

 

On the day before the surgery take

Two tablets at 10:30 am and  1:30 pm

 

 

[X] Label yes     Refill NO

 

 

_______________________________M.D.

Substitution Permitted