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Flashcards in Mannitol Deck (19)
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1
Q

What are the trade names for Mannitol?

A

Osmitrol, Resectisol

2
Q

What is the formal drug classification of Mannitol?

A

Osmotic Diuretic

6-Carbon Sugar

3
Q

What are the clinical uses of Mannitol (5)?

A
  • reduces increased ICP associated with cerebral edema
  • Prevention, differential diagnosis and treatment of oliguria/anuria
  • Reduces IOP
  • Promotes urinary excretion of toxic substances (ie radio-contrast dye)
  • GU irrigant in transurethral prostatic resection
4
Q

What is the MOA of Mannitol?

A

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
5
Q

Is mannitol reabsorbed? Explain!

A

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

6
Q

What is the ultimate effect of Mannitol?

A

INCREASED urine output

7
Q

What is the onset of action of Mannitol?

A

15 minutes

8
Q

What is the DOA of Mannitol?

A

3-6 hours

9
Q

How is mannitol metabolized and eliminated?

A

NOT metabolized; eliminated unchanged in the urine- only means of clearance= Glomerular Filtration

10
Q

What is the Volume of Distribution of Mannitol?

A

Remains confined to extracellular space (except in extreme concentrations) does NOT penetrate blood brain barrier

11
Q

What is the half life of Mannitol?

A

1.1 - 1.6 hours

12
Q

What are the side effects of Mannitol?

A
  • Headache
  • Convulsions
  • Rash
  • N/V
  • Blurred Vision
  • Polyuria
  • dysuria
  • 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
13
Q

What can prolonged use of Mannitol cause?

A

Hypovolemia
Electrolyte Imbalance
Plasma Hyperosmolarity

14
Q

What are the contraindications to the use of Mannitol?

A
  • Hypersensitvity to mannitol or any component of the formula
  • Severe renal disease
  • Dehydration
  • Active Intracranial Bleeding
  • Severe pulmonary Edema or congestion
  • Severe myocardial dysfunction (unable to handle rapid expansion of intravascular volume)
15
Q

What should you establish first before administering mannitol?

A

Renal and Myocardial function! Give test dose

16
Q

What is the drug interaction with Mannitol?

A

Lithium Toxicity!!!! (with diuretic induced hyponatremia)

17
Q

What is the dosage of Mannitol?

A

0.25 - 1 g/kg IV over 30-60 minutes

18
Q

When should you administer Mannitol in an in line 5-micron filter set

A

with concentrations > than 20%

19
Q

Do not adminster _________-___________ mannitol solution with blood

A

electrolyte-free