Mannitol: Difference between revisions
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==General== | ==General== | ||
*Type: | *Type: sugar alcohol, derived from mannose, stereo-isomer of sorbitol | ||
*Dosage Forms: Reconstituted powder and solution | *Dosage Forms: Reconstituted powder and solution<ref>[http://www.medicinenet.com/mannitol-injectable/article.htm</ref> | ||
**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 | *Common Trade Names: Mannitol, Osmitrol | ||
==Adult | ==Dosing== | ||
===[[Elevated intracranial pressure]]=== | ===Adult=== | ||
*0.25-2 | ====[[Elevated intracranial pressure]]==== | ||
*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) | |||
==Pediatric Dosing== | ===Pediatric Dosing=== | ||
====Cerebral edema==== | |||
*0.25-1 g/kg IV initially; maintenance dose of 0.25-0.5 g/kg IV q4-6hr<ref>http://reference.medscape.com/drug/osmitrol-mannitol-343061</ref> | |||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | ||
*Lactation: | *Lactation: | ||
** Unknown if present in breast milk | |||
*Renal Dosing | *Renal Dosing | ||
**Adult | **Adult | ||
*** Contraindicated in severe renal impairment | |||
**Pediatric | **Pediatric | ||
*** Contraindicated in severe renal impairment | |||
*Hepatic Dosing | *Hepatic Dosing | ||
**Adult | **Adult | ||
*** No adjustment necessary | |||
**Pediatric | **Pediatric | ||
*** No adjustment necessary | |||
==Indications== | ==Indications== | ||
| Line 30: | Line 42: | ||
==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== | ||
==References== | |||
<references/> | <references/> | ||
[[Category: | * Mannitol (systemic): Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019. | ||
[[Category:Pharmacology]] | |||
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
- Adult
- Hepatic Dosing
- Adult
- No adjustment necessary
- Pediatric
- No adjustment necessary
- Adult
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
- ↑ [http://www.medicinenet.com/mannitol-injectable/article.htm
- ↑ http://www.medicinenet.com/mannitol-injectable/article.htm
- ↑ http://www.cochrane.org/CD001049/INJ_mannitol-for-acute-traumatic-brain-injury
- ↑ http://reference.medscape.com/drug/osmitrol-mannitol-343061
- ↑ 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.