Cardiovascular Medicine Book

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Mannitol

Aka: Mannitol
  1. Indications
    1. Acute Severe Intracranial Pressure Management (cereral edema with Brainstem Herniation)
    2. Narrow Angle Glaucoma
  2. Contraindications
    1. Congestive Heart Failure (transient increase in CVP)
    2. Hypertension
    3. Pulmonary Edema
  3. Mechanism
    1. Alcohol found naturally in fruits and vegetables
      1. Six-carbon sugar Alcohol
      2. Formed from reduction of mannose or fructose
    2. Acts as 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
  4. Adverse Effects
    1. Headache
    2. Nausea
    3. Vomiting
    4. Lethargy
    5. Dizziness
  5. Precautions
    1. Filter solutions with concentration >20% (due to risk of crystallization)
    2. Monitor serum electolytes (e.g. basic chemistry panel) and fluid status
  6. Preparations
    1. Available as solution concentrations: 15% , 20% , 25%
  7. Dosing: 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
  8. References
    1. Olson (2020) Clinical Pharmacology, Medmaster, Miami, p. 62-3
    2. Hamilton (2010) Tarason Pocket Pharmacopeia, p. 224

Mannitol (C0024730)

Definition (NCI) A naturally occurring alcohol found in fruits and vegetables and used as an osmotic diuretic. Mannitol is freely filtered by the glomerulus and poorly reabsorbed from the renal tubule, thereby causing an increase in osmolarity of the glomerular filtrate. An increase in osmolarity limits tubular reabsorption of water and inhibits the renal tubular reabsorption of sodium, chloride, and other solutes, thereby promoting diuresis. In addition, mannitol elevates blood plasma osmolarity, resulting in enhanced flow of water from tissues into interstitial fluid and plasma.
Definition (NCI_NCI-GLOSS) A drug used to decrease swelling of the brain and to treat kidney failure. Mannitol can also be used to open the blood-brain barrier, which allows anticancer medicines to enter the brain and treat brain tumors.
Definition (MSH) A diuretic and renal diagnostic aid related to sorbitol. It has little significant energy value as it is largely eliminated from the body before any metabolism can take place. It can be used to treat oliguria associated with kidney failure or other manifestations of inadequate renal function and has been used for determination of glomerular filtration rate. Mannitol is also commonly used as a research tool in cell biological studies, usually to control osmolarity.
Definition (CSP) six-carbon sugar alcohol formed by reduction of mannose or fructose and widely distributed in plants and fungi.
Definition (PDQ) A naturally occurring alcohol found in fruits and vegetables and used as an osmotic diuretic. Mannitol is freely filtered by the glomerulus and poorly reabsorbed from the renal tubule, thereby causing an increase in osmolarity of the glomerular filtrate. An increase in osmolarity limits tubular reabsorption of water and inhibits the renal tubular reabsorption of sodium, chloride, and other solutes, thereby promoting diuresis. In addition, mannitol elevates blood plasma osmolarity, resulting in enhanced flow of water from tissues into interstitial fluid and plasma. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39493&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39493&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C625" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Carbohydrate (T118)
MSH D008353
SnomedCT 273946009, 30761007, 387168006
LNC LP15722-9, MTHU015736, LP173649-7
English Mannitol, MANNITOL USP, mannitol, mannitol (medication), Mannitol, D-, MANNITOL, Mannitol [Chemical/Ingredient], d-mannitol, d mannitol, D-Mannitol, Cordycepic acid, D-mannitol, E421 - Mannitol, Mannitol product, Mannitol (product), Mannitol (substance)
Swedish Mannitol
Czech mannitol
Finnish Mannitoli
Russian MANNITOL, MANNIT, МАННИТ, МАННИТОЛ
Croatian MANITOL
Polish Mannitol
Japanese マンニット, マンニトール
Spanish D-manitol, manitol (producto), manitol (sustancia), manitol, Manitol
French Mannitol
German Mannitol
Italian Mannitolo
Portuguese Manitol
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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