Mannitol

Mannitol has a powerful diuretic effect on the body.

[1], [2], [3]

Indications of the mannita

It is used in such cases:

• with cerebral puffiness, and also HFG, against which the liver / kidney insufficiency develops;
• in oliguria accompanied by an acute form of hepatic or renal insufficiency, in which filtration renal activity persists - in the form of combined treatment;
• with complications after transfusion procedures due to blood transfusion, which is not fully compatible with the body;
• in the procedures of forced diuresis, which is performed with intoxication with salicylates or barbiturates;
• to prevent the development of hemolysis during surgical intervention, which uses extracorporeal blood flow to avoid renal ischemia and possible kidney failure in the acute stage.

[4]

Release form

The release is carried out in the form of an infusion solution, which is contained in glass bottles with a volume of 200 or 400 ml. In a pack - 1 bottle.

[5], [6]

Pharmacodynamics

Mannitol is an osmotic diuretic that helps to keep the fluid inside the kidneys, and also increases the amount of urine. This occurs with the help of high plasma pressure and filtration processes carried out inside the glomeruli of the kidneys without activating the tubular reabsorption. The effect of drugs is mainly on the proximal tubules, but it has a slight effect on the descending nephron loop, together with the collecting tubules.

The active component does not pass through the walls of cells and tissues, and does not increase the value of residual nitrogen inside the blood. As a result of an increase in plasma osmolarity, fluid is transported from separate 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 dosage of drugs.

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

[7], [8], [9], [10], [11]

Pharmacokinetics

It was found that mannitol has a weak absorption from the gastrointestinal tract, which is why it is released in the form of a solution for IV injections.

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

The half-life is about 1.5 hours. Excretion is carried out with the involvement of the kidneys.

[12], [13], [14], [15]

Dosing and administration

Entering a medicinal solution of the drug is required in / in the method (slowly struino or drip).

During the implementation of preventive procedures, the dose is calculated in a 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 enter is 140-180 g.

The solution must be warmed before performing the infusion (up to 37 ° C). If procedures are performed with artificial blood flow, it is necessary to inject the solution into the apparatus (a portion of 20-40 g) before the perfusion is started.

During the treatment of oliguria, the patient is first introduced a test portion of the solution in / in the method, drip. After that, his condition is monitored for about 2-3 hours. To abolish the use of drugs is required if the rate of diuresis does not increase to 30-50 ml / hour.

[17], [18], [19], [20]

Use of the mannita during pregnancy

Pregnant and lactating women Mannit is administered with caution.

Contraindications

The main contraindications:

• severe intolerance of the drug;
• anuria, provoked by acute form of necrosis of renal tubules;
• failure of the left ventricle;
• stroke of hemorrhagic nature;
• hemorrhage of the subarachnoid type;
• severe dehydration;
• hypochloremia, hyponatremia, or hypokalemia.

Caution is required when administering the solution to the elderly.

[16]

Side effects of the mannita

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

Overdose

Intoxication can develop not only in connection with the use of excessively large doses of the solution, but also because of the rapid infusion of drugs. Among the manifestations: increased values of ICP and IOP, hypervolemia, stress on cardiac function and so on.

[21],

Interactions with other drugs

The combined use of Mannit with other diuretics can significantly potentiate their mutual effects on the body.

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

Together with this, Mannitol is able to potentiate the toxic effect of SG when combined with them.

[22], [23], [24], [25], [26]

Storage conditions

Mannitol is kept in a place where moisture and sunlight do not penetrate, and also inaccessible to children.

[27]

Special instructions

Reviews

Mannitol is often used both for the treatment of adults and children. Reviews about it testify to its high efficiency. The solution is effective in the treatment of pediatric hydrocephalus, helping to reduce pain and improve the baby's sleep.

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

If there are negative manifestations during the therapy, you should immediately notify the doctor about it. The specialist can cancel the medicine and replace it with an analog that will be more suitable for the patient.

Shelf life

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