Mannitol

Mannitol has a powerful diuretic effect on the body.

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Indications Mannita

It is used in the following cases:

• in case of cerebral edema, as well as intracranial hypertension, against the background of which liver/kidney failure develops;
• in oliguria accompanied by acute liver or kidney failure, in which renal filtration activity is preserved - in the form of combination treatment;
• in case of complications after transfusion procedures due to the transfusion of blood that is not fully compatible with the body;
• during forced diuresis procedures, which are carried out in cases of intoxication with salicylates or barbiturates;
• to prevent the development of hemolysis during surgical interventions in which extracorporeal blood flow is used to avoid renal ischemia and possible renal failure in the acute stage.

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Release form

The product is released in the form of an infusion medicinal solution, which is contained in glass bottles with a volume of 200 or 400 ml. There is 1 bottle in a pack.

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Pharmacodynamics

Mannitol is an osmotic diuretic that helps retain fluid within the renal tubules and increases urine volume. This occurs through high plasma pressure and filtration processes within the renal glomeruli without activating tubular reabsorption. The drug acts primarily on the proximal tubules, but it also has a small effect on the descending nephron loop and collecting ducts.

The active component does not pass through the walls of cells and tissues, and does not increase the value of residual nitrogen in the blood. As a result of the increase in plasma osmolarity, fluid is transported from individual tissues into the vascular bed.

Against the background of diuresis, there is a moderate increase in natriuresis, which has little effect on the process of potassium excretion. The diuretic effect increases in accordance with the increase in the dosage of the drug.

The drug should not be prescribed to people with problems of renal filtration, ascites and azotemia, against the background of which liver cirrhosis occurs, because this can increase the volume of circulating blood.

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Pharmacokinetics

It has been found that mannitol has poor absorption from the gastrointestinal tract, which is why it is released in the form of a solution for intravenous injection.

Inside the body, the component is distributed in the extracellular region, and its concentration is maintained for approximately 3 hours. Mannitol is weakly metabolized in the liver, being converted as a result of this process into glycogen.

The half-life is about 1.5 hours. Excretion occurs with the participation of the kidneys.

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Dosing and administration

The medicinal solution of the medicine must be administered intravenously (slowly by jet or drip).

During preventive procedures, the dose is calculated in the ratio of 0.5 g/kg. The size of the medicinal portion is about 1.0-1.5 g/kg. The maximum amount of medicine that is allowed to be administered is 140-180 g.

The solution must be warmed before infusion (up to 37°C). If procedures with artificial blood flow are performed, the solution must be introduced into the device (the portion is 20-40 g) before the start of perfusion.

During the treatment of oliguria, the patient is first given a test portion of the solution intravenously, drip by drip. After that, his condition is monitored for approximately 2-3 hours. The use of the drug should be discontinued if the diuresis rate does not increase to 30-50 ml/hour.

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Use Mannita during pregnancy

Mannitol is prescribed to pregnant and lactating women with caution.

Contraindications

Main contraindications:

• severe intolerance to the drug;
• anuria caused by acute renal tubular necrosis;
• left ventricular failure;
• hemorrhagic stroke;
• subarachnoid hemorrhage;
• severe stage of dehydration;
• hypochloremia, hyponatremia or hypokalemia.

Caution is required when prescribing the solution to elderly people.

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Side effects Mannita

During the use of the drug, side effects such as dehydration, accompanied by dry skin and mouth, a feeling of thirst, dyspeptic symptoms, muscle weakness, hallucinations and convulsions, and in addition to this, a decrease in blood pressure values, may occur. Along with this, water-electrolyte imbalance, pain in the chest area, tachycardia with thrombophlebitis and rashes may develop.

Overdose

Intoxication may develop not only due to the use of excessively large doses of the solution, but also due to rapid infusion of the drug. Among the manifestations: increased values of ICP and IOP, hypervolemia, stress on cardiac function, etc.

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Interactions with other drugs

The combined use of Mannitol with other diuretic drugs can significantly potentiate their mutual effect on the body.

When combined with neomycin, the nephrotoxic and ototoxic properties of the drug are enhanced.

At the same time, Mannitol is capable of potentiating the toxic effect of SG when used in combination with them.

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Storage conditions

Mannitol should be kept in a place protected from moisture and sunlight, and out of the reach of children.

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Special instructions

Reviews

Mannitol is often used to treat both adults and children. Reviews of it indicate its high effectiveness. The solution works effectively in the treatment of childhood hydrocephalus, helping to reduce pain and improve the child's sleep.

But there are also comments showing that the drug, in addition to improvement, can lead to the development of negative reactions (chest pain or tachycardia).

If negative effects occur during therapy, you must immediately notify your doctor. The specialist can cancel the drug and replace it with an analogue that is more suitable for the patient.

Shelf life

Mannitol can be used for 3 years from the date of manufacture of the medicinal solution.