Mannitol

Mannitol most extensively employed as osmotic diuretic. its D-enantiomer is used clinically.it opposes reabsorption of water which normally accompanies sodium reabsorption from kidney tubule. Used when there is a danger renal failure (e.g shock, cardiovascular surgery) and in fluid overload refactory to other diuretics. May cause cardiac failure owing to increase circulating blood volume. Mannitoladministered by intravenous infusion.


Adult Dose
Dose: 0.2 g/ kg/dose
Single Dose: 0.2 (0.2)
Frequency: As recommended.
Route: IV Inf
Instructions: Test Dose, Max. 12.5gm over 3-5 min, If there is no diuresis within 2 hrs. discontinue mannitol
Neonatal
Dose: 16.66 to 66.66 mg/kg.min
Single Dose: 42 (41.66)
Frequency: As recommended.
Route: IV Infusion
Instructions: Infuse over 30 min.Repeat the dose as required
Paedriatic
Dose: 0.25 to 0 g/ug
Single Dose: 0.12 (0.125)
Frequency: As recommended.
Route:
Instructions:
Characteristics
Mannitol also known as Manna sugar, Manna sugar. . It is of Synthetic origin and belongs to Sugar Alcohol. . The Molecular Weight of Mannitol is 182.20. It is weakly acidic drug, 5.07% solution of the drug is isotonic.
Contraindications
Mannitol is contraindicated in conditions like Acidosis,Congestive heart failure,Pulmonary edema,Intracranial hemorrhage,Dehydration,Inadequate urine flow.
Effects
The severe or irreversible adverse effects of Mannitol, which give rise to further complications include Dehydration, Hyponatremia, Oedema, Skin necrosis, Hyponatremia, Inflammation.Mannitol produces potentially life-threatening effects which include Pulmonary edema, Convulsions, Hypertension, Hypotension, Anaphylaxis, Fluid & electrolyte imbalance, Water intoxication. which are responsible for the discontinuation of Mannitol therapy.The signs and symptoms that are produced after the acute overdosage of Mannitol include Coma, Confusion, Lethargy, Stupor, Severe hyponatremia.The symptomatic adverse reactions produced by Mannitol are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Thirst, Headache, Nausea, Vomiting, Fever, Tachycardia, Blurred vision, Chills, Thrombophlebitis, Hypokalemia, Chest pain, Xerostomia, Urinary RetentionX, Urinary retention, dizziness.
Indications
Mannitol is primarily indicated in conditions like Bladder irrigation, Cerebral oedema, Diuresis, Edematous states, Oliguria, Poisoning, Raised intracranial pressure, Raised iop, Renal insufficiency, Reperfusion injury, Sodium depletion, Termination of pregnancy.
Interactions
Mannitol is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementCisplatinDigoxinLithiumMetaraminolNoradrenaline (Acid Tartrate)Potassium ChlorideSodium ChlorideStreptomycin SulphateOtotoxic effects of Streptomycin sulphate increases by co administration of mannitol.Suxamethonium (Cl)Tetracycline (HCl) These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
False +ve estimation of Ethylene Glycol Some methods of Serum Inorganic Phosphates
Risks
Drug should not be given to Paediatrics, Pregnant Mothers, Cardiac / Hypertensive Patients, Geriatrics, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Inj Store Below 40°C. Do not Freeze. Protect from Sunlight.
Warnings
Before rapid administration of mannitol carefully evaluate patients cardiovascular status because sudden expansion of extracellular fluid lead to congestive heart failure (CHF). The diuretic response following 15-20% of mannitol may further aggravate pre-existing hemoconcentration. Mannitol should not be administered untill the patient renal function and urine flow have been determined to be adequate using a test dose. The drug should be administered to the pregnant mother only when the potential benefits to the mother outweigh the potential risks to the fetus.
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