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mannitol |
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mannitol /man·ni·tol/ (man´i-tol) a sugar alcohol formed by reduction of mannose or fructose and widely distributed in plants and fungi; an osmotic diuretic used to prevent and treat acute renal failure, to promote excretion of toxic substances, to reduce cerebral edema or elevated intracranial or intraocular pressure, and to prevent hemolysis during transurethral surgical procedures.
mannitol (man´itol´), n a poorly metabolized sugar used as an osmotic diuretic and in kidney function tests. mannitol a sugar alcohol occurring widely in nature, especially in fungi; utilization of mannitol is used in identification of some bacteria; used in diagnostic tests of kidney function and as an osmotic diuretic, particularly in the treatment of cerebral edema and oliguric acute renal failure. mannitol Osmitrol, Resectisol Pharmacologic class: Osmotic diuretic Therapeutic class: Diuretic Pregnancy risk category C ActionIncreases osmotic pressure of plasma in glomerular filtrate, inhibiting tubular reabsorption of water and electrolytes (including sodium and potassium). These actions enhance water flow from various tissues and ultimately decrease intracranial and intraocular pressures; serum sodium level rises while potassium and blood urea levels fall. Also protects kidneys by preventing toxins from forming and blocking tubules. AvailabilityInjection: 5%, 10%, 15%, 20%, 25% Solution: 5 g/100 ml ⊘Indications and dosages ➣ Test dose for marked oliguria or suspected inadequate renal function Adults: 0.2 g/kg I.V. infusion (approximately 50 ml of 25% solution, 75 ml of 20% solution, or 100 ml of 15% solution) over 3 to 5 minutes. If urine flow doesn't increase, second dose may be given; if response is inadequate after second dose, reevaluate patient. ➣ To prevent acute renal failure during cardiovascular and other surgeries Adults: 50 to 100 g I.V. infusion as 5% to 25% solution, up to 6 g/kg/day ➣ Acute renal failure Adults: 50 to 100 g I.V. infusion as 15% to 25% solution, up to 6 g/kg/day ➣ To reduce intracranial pressure and brain mass Adults: 0.5 to 2 g/kg I.V. infusion as 15% to 25% solution given over 30 to 60 minutes ➣ To reduce intraocular pressure Adults: 0.5 to 2 g/kg I.V. infusion as 15% to 25% solution given over 30 to 60 minutes. For preoperative use, give 60 to 90 minutes before surgery. ➣ To promote diuresis in drug toxicity Adults: 25 g I.V. infusion as loading dose, followed by infusion of 5% to 25% solution given continuously to maintain high urine output ➣ Irrigation during transurethral resection of prostate Adults: 2.5% to 5% solution instilled into bladder via indwelling urethral catheter, as needed Contraindications• Active intracranial bleeding (except during craniotomy) PrecautionsUse cautiously in: Administration☞ Withhold drug until adequate renal function and urinary output are established.
Adverse reactionsCNS: dizziness, headache, seizures CV: chest pain, hypotension, hypertension, tachycardia, thrombophlebitis, heart failure, vascular overload EENT: blurred vision, rhinitis GI: nausea, vomiting, diarrhea, dry mouth GU: polyuria, urinary retention, osmotic nephrosis Metabolic: dehydration, water intoxication, hypernatremia, hyponatremia, hypovolemia, hypokalemia, hyperkalemia, metabolic acidosis Respiratory: pulmonary congestion Skin: rash, urticaria Other: chills, fever, thirst, edema, extravasation with edema and tissue necrosis InteractionsDrug-drug. Digoxin: increased risk of digoxin toxicity Diuretics: increased therapeutic effects of mannitol Lithium: increased urinary excretion of lithium Drug-diagnostic tests. Electrolytes: increased or decreased levels Patient monitoring☞ Monitor I.V. site carefully to avoid extravasation and tissue necrosis. Patient teaching• Teach patient about importance of monitoring exact urinary output. |
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