Mannitol

Mannitol – osmotic diuretic means.

Form of release and structure

Dosage form – solution for infusions: transparent colourless liquid (on 200 or 400 ml in glass large bottles, in a cardboard pack 1 large bottle, in a box cardboard 12 or 24 packs; on 100, 200, 400 ml in large bottles for blood and blood substitutes, on 1 large bottle in a cardboard pack or on 15 or 28 large bottles in a box of corrugated fibreboard).

Active ingredient of the Mannitol – Mannitolum, in 1 ml – 0,15 g.

Auxiliary components: sodium chloride, water for injections.

Indications to use

• The intracranial hypertensia (caused renal or a renal liver failure), wet brain;
• Artificial diuresis in case of poisoning with salicylates, barbiturates;
• Combination therapy of an oliguria in case of acute renal or a renal liver failure with the operating filtrational ability of kidneys;
• The posttransfusion complications which arose against the background of administration of incompatible blood;
• Prevention of hemolysis when carrying out surgeries with use of extracorporal blood circulation (for the prevention of ischemia of kidneys and an acute renal failure).

Contraindications

• Hemorrhagic stroke;
• Subarachnoidal hemorrhage, not including bleedings at a craniotrypesis;
• Left ventricular failure (especially, at the accompanying fluid lungs);
• Anury at an acute necrosis of tubules of kidneys;
• Severe form of dehydration;
• Hypochloraemia, hyponatremia, hypopotassemia;
• Hypersensitivity to drug components.

With care it is recommended to apply the Mannitol during pregnancy, breastfeeding, at patients of advanced age.

Route of administration and dosage

The mannitol is intended for intravenous (in/in) drop or slow jet introduction. Before use solution needs to be warmed up on the water bath up to the temperature of 37 °C.

The recommended daily dosing:

• Prevention: from calculation for 0,5 g on 1 kg of weight of the patient;
• Treatment: on 1-1,5 g on 1 kg of weight, but no more than 140-180 g a day.

At surgeries with use of artificial circulation of 20-40 g of solution enter into the device prior to perfusion.

Before an initiation of treatment of patients with an oliguria administration of drug in a dose of 0,2 g on 1 kg of weight is required trial in/in drop (within 3-5 minutes). In the absence of increase in speed of a diuresis to 30-50 ml/h 2-3 hours later after infusion further use of drug is not reasonable.

Side effects

• Metabolism: dehydration (thirst, dryness in a mouth, muscular weakness, a xeroderma, dyspepsia, spasms, lowering of arterial pressure (ABP), hallucinations), disturbance of water and electrolytic balance (a hypopotassemia (seldom), a hyponatremia, increase in volume of the circulating blood);
• Others: seldom – skin rash, pain behind a breast, tachycardia, thrombophlebitis.

Special instructions

Because of big risk of edematization of lungs at patients with a left ventricular failure use of the Mannitol needs to be combined with loopback diuretics of bystry action. Treatment should be accompanied with control of the ABP, a diuresis, content of electrolytes (potassium, sodium) in blood serum.

At repeated use of Mannitolum it is necessary to control indicators of water and electrolytic balance carefully.

Before administration of drug it is necessary to warn the patient about need of informing medical staff on emergence of a headache, a vision disorder, symptoms of vomiting, dizziness during infusion. In case of receipt of the specified complaints further introduction it is necessary to stop and take measures for prevention of development of subdural and subarachnoidal bleeding.

In case of symptoms of dehydration it is necessary to provide administration of liquid.

Use of drug at heart failure is possible only in combination with loopback diuretics.

The mannitol is appointed at hypertensive crisis with encephalopathy.

Medicinal interaction

At a hypopotassemia simultaneous use of Mannitolum can increase toxic effect of cardiac glycosides.

Terms and storage conditions

To protect from children.

To store at a temperature not above 20 °C, not to allow freezing.

Period of validity – 3 years.