Flashcards in Mannitol Deck (19)
What are the trade names for Mannitol?
What is the formal drug classification of Mannitol?
What are the clinical uses of Mannitol (5)?
-reduces increased ICP associated with cerebral edema
-Prevention, differential diagnosis and treatment of oliguria/anuria
-Promotes urinary excretion of toxic substances (ie radio-contrast dye)
-GU irrigant in transurethral prostatic resection
What is the MOA of Mannitol?
Increases the osmolarity of the plasma, glomerular filtrate, and renal tubular fluid
-this promotes the movement of intracellular and extracellular fluid into the plasma and out of such places such as brain tissue. This will temporarily increase plasma volume
-Eventually, diuresis will occur as a result of the fact mannitol is filtered but NOT reabsorbed from renal tubules.
-also promotes flow to the renal medulla and is an oxygen free radical scavenger
Is mannitol reabsorbed? Explain!
NO! It is filtered but NOT reabsorbed from renal tubules
-as the mannitol is filtered, it draws fluid and electrolytes such as sodium, chloride, and bicarbonate into the urine
What is the ultimate effect of Mannitol?
INCREASED urine output
What is the onset of action of Mannitol?
What is the DOA of Mannitol?
How is mannitol metabolized and eliminated?
NOT metabolized; eliminated unchanged in the urine- only means of clearance= Glomerular Filtration
What is the Volume of Distribution of Mannitol?
Remains confined to extracellular space (except in extreme concentrations) does NOT penetrate blood brain barrier
What is the half life of Mannitol?
1.1 - 1.6 hours
What are the side effects of Mannitol?
-acute and dramatic increase in intravascular fluid volume, pulmonary edema in patients with oliguria secondary to cardiac failure or in those with poor baseline myocardial function
What can prolonged use of Mannitol cause?
What are the contraindications to the use of Mannitol?
-Hypersensitvity to mannitol or any component of the formula
-Severe renal disease
-Active Intracranial Bleeding
-Severe pulmonary Edema or congestion
-Severe myocardial dysfunction (unable to handle rapid expansion of intravascular volume)
What should you establish first before administering mannitol?
Renal and Myocardial function! Give test dose
What is the drug interaction with Mannitol?
Lithium Toxicity!!!! (with diuretic induced hyponatremia)
What is the dosage of Mannitol?
0.25 - 1 g/kg IV over 30-60 minutes
When should you administer Mannitol in an in line 5-micron filter set
with concentrations > than 20%