Mannitol, 150mg/ml 400 ml 1pc.

Mannitol is an osmotic diuretic. Theoretical osmolarity is 1132 mosm/l. By increasing plasma osmotic pressure and filtration without subsequent tubular reabsorption leads to water retention in the tubules and increased urine volume.

Augmenting blood plasma osmolarity causes movement of fluid from tissues (in particular the eyeball, brain) into the vascular bed. It does not affect glomerular filtration.

Diuresis is accompanied by a moderate increase in natriuresis without a significant effect on the excretion of potassium ions. The diuretic effect is greater the higher the dose.

It is not effective in impaired renal filtration function and in azotemia in patients with cirrhosis and ascites. Causes an increase in circulating blood volume.

Indications

Active ingredient

Composition

In 1 liter of solution contains:

Active substance:

Mannitol (mannitol) 150 g;

Associates:

Sodium chloride 9 g,

Injection water up to 1 liter.

How to take, the dosage

Intravenously, slowly by trickle or drip.

The prophylactic dose is 0.5 g/kg, therapeutic dose is 1-1.5 g/kg; the daily dose should not exceed 140-180 g.

The drug should be heated to a temperature of 37 ° C (can be in a water bath) before administration.

In operations with artificial circulation the drug is administered in a dose of 20-40 g immediately before perfusion.

Patients with oliguria should be given a test dose (200 mg/kg) by IV drip beforehand for 3-5 minutes. If no increase in diuresis rate to 30-50 ml/h is noted within 2-3 h thereafter, the drug should be refrained from further administration.

Interaction

The toxic effects of cardiac glycosides may be increased (associated with hypokalemia).

Special Instructions

In case of left ventricular insufficiency (due to the risk of pulmonary edema), Mannitol should be combined with fast-acting loop diuretics. It is necessary to control BP, diuresis, and concentration of electrolytes in blood serum (sodium and potassium ions).

If headache, vomiting, dizziness, visual disturbances occur during drug administration, the administration should be discontinued and the development of such complications as subdural and subarachnoid bleeding should be excluded.

Possible use in heart failure (only in combination with loop diuretics) and hypertensive crisis with encephalopathy. Repeated administration of Mannitol should be carried out under control of blood parameters of water-electrolyte balance.

Possible cases of crystallization of the drug during storage (at temperatures below 20 ° C). In case of crystallization the bottle is heated to 50-70 ° C until the precipitate dissolves. Use after cooling to body temperature if crystals do not precipitate again.

Contraindications

Side effects

Dehydration (dry skin, dyspepsia, myasthenia gravis, convulsions, dry mouth, thirst, hallucinations, BP decrease), disorders of water-electrolyte metabolism (increase of the BCC, hyponatremia; rarely – hyperkalemia).

Rarely – tachycardia, chest pain, thrombophlebitis, skin rash.