Mannitol: Difference between revisions
 
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===Adult===
===Adult===
====[[Elevated intracranial pressure]]====
====[[Elevated intracranial pressure]]====
*0.25-2 G/kg given every 6 to 8 hours<ref>http://www.medicinenet.com/mannitol-injectable/article.htm</ref>
*0.25-2 g/kg given every 6 to 8 hours<ref>http://www.medicinenet.com/mannitol-injectable/article.htm</ref>
**Should be given as a one time bolus (may be inferior to Hypertonic Saline)<ref>http://www.cochrane.org/CD001049/INJ_mannitol-for-acute-traumatic-brain-injury</ref>
**Should be given as a one time bolus (may be inferior to Hypertonic Saline)<ref>http://www.cochrane.org/CD001049/INJ_mannitol-for-acute-traumatic-brain-injury</ref>
**Easy ED dosing: 1G/kg bolus in ED (while awaiting neurosurgery eval/admission)
**Easy ED dosing: 1g/kg bolus in ED (while awaiting neurosurgery eval/admission)


===Pediatric Dosing===
===Pediatric Dosing===
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==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
*Heart failure
*Worsening dehydration
*Hyponatremia
*Hypokalemia
*Hypocalcemia


===Common===
===Common===
*Cough
*Sore throat
*Dry mouth
*Headache
*Nausea


==Pharmacology==
==Pharmacology==
*Half-life:  
*Onset of action: 5-10 minutes
*Half-life: 6 hours
*Metabolism:  
*Metabolism:  
*Excretion:  
*Excretion: Urine
*Mechanism of Action:
*Mechanism of Action: Increased tonicity of mannitol draws water out of the brain parenchyma and into the intravascular space<ref>https://www.ncbi.nlm.nih.gov/books/NBK470392/#:~:text=Tenny%20S%2C%20Patel%20R%2C%20Thorell%20W.%20Mannitol.%20%5BUpdated%202022%20Feb%2021%5D.%20In%3A%20StatPearls%20%5BInternet%5D.%20Treasure%20Island%20(FL)%3A%20StatPearls%20Publishing%3B%202022%20Jan%2D.%20Available%20from%3A%20https%3A//www.ncbi.nlm.nih.gov/books/NBK470392/</ref>


==See Also==
==See Also==

Latest revision as of 14:37, 2 October 2022

General

  • Type: sugar alcohol, derived from mannose, stereo-isomer of sorbitol
  • Dosage Forms: Reconstituted powder and solution[1]
    • 5% and 10% in 1000ml containers
    • 15% in 500ml containers
    • 20% in 250ml and 500ml containers
    • 25% in 50ml flip-top vials
  • Common Trade Names: Mannitol, Osmitrol

Dosing

Adult

Elevated intracranial pressure

  • 0.25-2 g/kg given every 6 to 8 hours[2]
    • Should be given as a one time bolus (may be inferior to Hypertonic Saline)[3]
    • Easy ED dosing: 1g/kg bolus in ED (while awaiting neurosurgery eval/admission)

Pediatric Dosing

Cerebral edema

  • 0.25-1 g/kg IV initially; maintenance dose of 0.25-0.5 g/kg IV q4-6hr[4]

Special Populations

  • Pregnancy Rating: C
  • Lactation:
    • Unknown if present in breast milk
  • Renal Dosing
    • Adult
      • Contraindicated in severe renal impairment
    • Pediatric
      • Contraindicated in severe renal impairment
  • Hepatic Dosing
    • Adult
      • No adjustment necessary
    • Pediatric
      • No adjustment necessary

Indications

  • Lowering ICP with signs of impending herniation or severely deteriorating mental status in context of known trauma or intracranial lesion exerting mass effect

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

  • Heart failure
  • Worsening dehydration
  • Hyponatremia
  • Hypokalemia
  • Hypocalcemia

Common

  • Cough
  • Sore throat
  • Dry mouth
  • Headache
  • Nausea

Pharmacology

  • Onset of action: 5-10 minutes
  • Half-life: 6 hours
  • Metabolism:
  • Excretion: Urine
  • Mechanism of Action: Increased tonicity of mannitol draws water out of the brain parenchyma and into the intravascular space[5]

See Also

References

  1. ↑ [http://www.medicinenet.com/mannitol-injectable/article.htm
  2. ↑ http://www.medicinenet.com/mannitol-injectable/article.htm
  3. ↑ http://www.cochrane.org/CD001049/INJ_mannitol-for-acute-traumatic-brain-injury
  4. ↑ http://reference.medscape.com/drug/osmitrol-mannitol-343061
  5. ↑ https://www.ncbi.nlm.nih.gov/books/NBK470392/#:~:text=Tenny%20S%2C%20Patel%20R%2C%20Thorell%20W.%20Mannitol.%20%5BUpdated%202022%20Feb%2021%5D.%20In%3A%20StatPearls%20%5BInternet%5D.%20Treasure%20Island%20(FL)%3A%20StatPearls%20Publishing%3B%202022%20Jan%2D.%20Available%20from%3A%20https%3A//www.ncbi.nlm.nih.gov/books/NBK470392/
  • Mannitol (systemic): Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.
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