III. Contraindications

IV. Mechanism

  1. Mannitol is a sugar Alcohol found naturally in fruits and vegetables
    1. Six-carbon sugar Alcohol
    2. Formed from reduction of mannose or fructose
  2. Mannitol acts as an osmotic Diuretic
    1. Freely filtered by glomerulus, but poorly reabsorbed at renal tubule
    2. Increases osmolarity of glomerular fluid, resulting in diuresis (water, Sodium, chloride)
  3. Increases plasma osmolarity
    1. Draws water from cells into plasma and interstitial fluid
    2. Transiently reduces tissue edema and increases plasma volume and Blood Pressure
      1. Later, fluid and Electrolyte redistribution results in Hypotension and Electrolyte abnormalities

V. Adverse Effects

VI. Precautions

  1. Filter solutions with concentration >20% (due to risk of crystallization)
  2. Monitor serum electolytes (e.g. basic chemistry panel) and fluid status

VII. Dosing

  1. Available as solution concentrations: 15% , 20% , 25%
  2. Intracranial Hypertension
    1. Dose: 0.25 to 1 g/kg IV over 20 minutes every 4-6 hours as needed
    2. Single dose of 1-2 g IV may be given over 30-60 minutes

IX. References

  1. Olson (2020) Clinical Pharmacology, Medmaster, Miami, p. 62-3
  2. Hamilton (2010) Tarason Pocket Pharmacopeia, p. 224

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