Mannitolum

Mannitolum – osmotic diuretic with antiedematous effect.

Form of release and structure

Dosage form – solution for infusions of 15%: colourless transparent liquid (200, 400 ml in glass bottles for blood or blood substitutes).

Active ingredient – a mannitol, in 1 ml – 0,15 g.

Auxiliary components: sodium chloride, water for injections.

Indications to use

• Bad attack of glaucoma;
• Epileptic status;
• Wet brain;
• Intracranial hypertensia at patients with renal or a renal liver failure;
• Posttransfusion reactions after incompatible blood transfusion;
• Oliguria against the background of an acute renal and hepatic or renal failure with the kept filtrational function of kidneys (as a part of complex therapy);
• Artificial diuresis at poisoning with salicylates and barbiturates;
• Prevention of hemolysis when carrying out operations with use of devices of extracorporal blood circulation (prevention of ischemia of kidneys or an acute renal failure).

Contraindications

• Hemorrhagic stroke;
• Anury at an acute necrosis of tubules at patients with the expressed pathology of kidneys;
• Tyazhelya organism dehydration form;
• Subarachnoidal hemorrhage, except the cases connected with bleeding at a craniotrypesis;
• Chronic heart failure;
• Fluid lungs at patients with an acute left ventricular failure;
• Hyponatremia, hypochloraemia, hypopotassemia;
• Hypersensitivity to drug components.

With care it is recommended to appoint Mannitolum during pregnancy and breastfeeding.

Route of administration and dosage

Solution is intended for intravenous (in/in) slow jet or drop introduction.

Dosing mode:

• 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.

When carrying out surgeries with use of extracorporal blood circulation it is necessary to enter 20-40 g of drug into the device just before perfusion.

At treatment of an oliguria trial introduction of Mannitolum is required, for this purpose to the patient in/in enter a dose of the corresponding 0,2 g on each kg of weight within 3-5 minutes. Further use of drug is inexpedient if within 2-3 hours after trial introduction the speed of a diuresis did not increase to 30-50 ml/h.

Side effects

• Metabolism: disturbances of water and electrolytic exchange – a hyperpotassemia (seldom), a hyponatremia, increase in level of volume of the circulating blood; against the background of dehydration – thirst, dryness in a mouth, dyspepsia, a xeroderma, muscular weakness, spasms, a lowering of arterial pressure (ABP), hallucinations;
• Others: seldom – skin rash, pains behind a breast, tachycardia, thrombophlebitis.

Special instructions

At loss of crystals solution should be warmed up on the water bath (temperature of 50-70 °C), periodically stirring up a bottle before full dissolution of crystals. If after cooling up to the temperature of 36-38 °C crystals drop out in a deposit again, drug cannot be used.

Because of risk of a fluid lungs use of Mannitolum at a left ventricular failure needs to be combined with high-speed loopback diuretics.

Administration of drug should be accompanied with control of a diuresis, the ABP, level of potassium concentration and sodium in blood serum.

At emergence in the patient during administration of drug of a headache, dizziness, vomiting, disturbance of visual perception the procedure it is necessary to stop and take the appropriate measures for an exception of development of subdural and subarachnoidal bleeding.

Administration of liquid is recommended to patients with symptoms of dehydration.

Use of a mannitol for patients with heart failure is possible only in combination with loopback diuretics.

Purpose of Mannitolum at hypertensive crisis with encephalopathy is shown.

Repeated administration of drug should be carried out under control of water and electrolytic balance.

Medicinal interaction

At simultaneous use of Mannitolum increase in toxic activity of cardiac glycosides at patients with a hypopotassemia is possible.

Terms and storage conditions

To protect from children.

To store in the dry place at a temperature of 18-20 °C.

Period of validity – 3 years.