Generic Name: Mannitol

Brand Name: Osmitrol

Drug Classification: Osmotic Diuretic

Desired Dose:

0.5 to 2 g/kg I.V. infusion as 15% to 25% solution given over 30 – 60 minutes.

Mechanism of Action:

Increases osmotic pressure of plasma in glomerular filtrate, inhibiting tubular reabsorption of water and
electrolytes (including sodium and potassium). These actions enhance water flow from various tissues
and ultimately decrease intracranial and intraocular pressures.

Indication:

Test dose for marked oliguria or suspected inadequate renal function, prevent acute renal failure during
cardiovascular and other surgeries, acute renal failure, to reduce intracranial pressure and brain mass,
reduce intraocular pressure, to promote dieresis in drug toxicity, irrigation during transurethral
resection of prostate.

Contraindication:

Active intracranial bleeding (except during craniotomy), anuria secondary to severe renal disease,
progressive heart failure, pulmonary congestion, renal damage, or renal dysfunction after mannitol
therapy begins, severe pulmonary congestion or pulmonary edema, and severe dehydration.

Side effects:

CNS: dizziness, headache, seizures

CV: chest pain, hypotension, hypertension, tachycardia, thrombophlebitis, heart failure, vascular
overload

EENT: blurred vision, rhinitis

GI: nausea, vomiting, diarrhea, dry mouth

GU: polyuria, urinary retention, osmotic nephrosis

Metabolic: dehydration, water intoxication, hypernatremia, hyponatremia, hypovolemia, hypokalemia,

hyperkalemia, metabolic acidosis
Respiratory: pulmonary congestion

Skin: rash, urticaria

Other: chills, fever, thirst, edema, extravasation with edema and tissue necrosis

Interaction:

Drug-drug: Digoxin, diuretics, lithium, other aminoglycosides, nephrotoxic drugs, ototoxic-producing

medications

Laboratory values: may increase BUN, SGOT (AST), SGPT (ALT), bilirubin, creatinine, LDH concentration,
may decrease serum Calcium, magnesium, potassium, sodium concentrations.

Nsg. Considerations:

1. Assesss skin turgor, mucous membranes and mental status before administration of drug.
2. Assess signs for electrolyte imbalance.
3. Monitor Vital signs including central venous pressure and output.
4. Store at room temperature.
5. Use a filter with concentrated mannitol (15%, 20% and 25%).
6. Be alert for adverse reactions and drug interactions.
7. Monitor hepatic and renal function during therapy.
8. Monitor IV site carefully to avoid extravasations and tissue necrosis
9. Do not add to other IV solutions or mix with other medications.
10. Watch for excessive fluid loss and signs and symptoms of hypovolemia and dehydration.
11. Assess for evidence of circulatory overload, including pulmonary edema, water intoxication, and
heart failure.