Universal reference book for medicines

Active substance: mannitol

Type: Osmotic diuretic

Manufacturer: МЕДПОЛИМЕР (Russia)
Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..
Osmotic diuretic. Increasing the osmotic pressure of the plasma and filtration without subsequent tubular reabsorption leads to water retention in the tubules and an increase in the volume of urine. Raising the osmolarity of the plasma, causes the fluid to move from the tissues (in particular, the eyeball, brain) to the vascular bed. Causes a pronounced diuretic effect, in which a large amount of osmotically free water, as well as sodium, chlorine, is removed without significant removal of potassium.
Causes an increase in bcc.
The volume of distribution corresponds to the volume of the extracellular fluid. Mannitol can undergo a slight metabolism in the liver with the formation of glycogen.
The excretion of mannitol is regulated by glomerular filtration without significant tubular reabsorption.
T 1/2 is about 100 minutes. It is excreted by the kidneys, with iv injection in a dose of 100 g 80% is determined in urine for 3 hours.
With renal insufficiency T 1/2 can increase up to 36 hours.
Edema of the brain. Intracranial hypertension. Epileptic status. Intraocular hypertension, acute attack of glaucoma.
Oliguria in acute renal failure. To determine the rate of glomerular filtration in acute oliguria.
Acute liver failure. Acute liver failure in patients with preserved filtration capacity of the kidneys and other conditions requiring an increase in diuresis.
Poisoning with barbiturates, salicylates, bromides, lithium preparations, forced diuresis in other poisonings.
Post-transfusion complications after the introduction of incompatible blood.
For prevention of hemolysis and hemoglobinemia in transurethral resection of the prostate gland or performing surgical manipulations such as shunting on the cardiopulmonary system, in operations with extracorporeal circulation.
Enter in / in (slowly stream or drip). The preventive dose is 500 mg / kg of body weight, the therapeutic dose is 1-1.5 g / kg. The daily dose should not exceed 140-180 g. In operations with extracorporeal circulation, a dose of 20-40 g is administered immediately before the operation.
Patients with oliguria should be previously injected into / drip a test dose of mannitol (200 mg / kg) for 3-5 minutes. If after this, within 2-3 hours there will be no increase in the rate of diuresis to 30-50 ml / g, then from further administration of mannitol should be refrained.
On the part of metabolism: violations of the water-electrolyte balance (increased bcc, hyponatremia of dilution, hyperkalemia) and their manifestations (muscle weakness, convulsions, dry mouth, thirst, impaired consciousness).
Other: tachycardia, chest pain, thrombophlebitis, skin rash.
Chronic renal failure, impaired filtration of the kidneys, left ventricular failure (especially accompanied by pulmonary edema), hemorrhagic stroke, subarachnoid hemorrhage (except for bleeding during trepanation of the skull), severe forms of dehydration, hyponatremia, hypochloremia, hypokalemia, hypersensitivity to mannitol.
Adequate and strictly controlled studies in humans have not been conducted.
The use of mannitol in pregnancy and during lactation is possible in cases where the intended benefit to the mother exceeds the possible risk to the fetus or infant.
Contraindicated in chronic renal failure, impaired filtration of the kidneys.
Use with caution in patients with impaired renal function.
Use with caution in patients with severe forms of chronic heart failure, hypovolemia, impaired renal function.
In case of appearance of such symptoms as mannitol such as headache, vomiting, dizziness, visual disturbances, it is necessary to stop the introduction and to exclude the development of such complication as subdural and subarachnoidal hemorrhage.
When using mannitol, it is necessary to monitor blood pressure, diuresis, the concentration of electrolytes in blood serum (potassium, sodium).
With the simultaneous use of mannitol with cardiac glycosides, it is possible to increase their toxic effect associated with hypokalemia.
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