D-mannitol, Mannitolum

Mannitolum (Latin Mannitol) - osmotic diuretic. The lyophilized mass of light yellow color. Let's dissolve in water (very easily — in hot).

Chemical name D - mannitol

Gross - a formula C6H14O6

CAS 69 - 65 - 8 code

Pharmacology

Pharmacological action - antiedematous, diuretic. Increases the osmotic pressure of plasma, promotes transition of liquid from fabrics in a vascular bed, increases OTsK. It is filtered by kidneys without the subsequent canalicular reabsorption, osmotic pressure in tubules raises and interferes with a water reabsorption that leads to keeping of water in tubules and to increase in volume of urine. At the same time considerably the natriuresis without essential increase in a kaliyurez increases. The diuretic effect of subjects is higher, than a high dose. About 80% entered into doses are found in urine during 3 h. It is not effective at disturbance of filtrational function of kidneys, and also at an azotemia at patients with cirrhosis and ascites. Can be exposed to an insignificant metabolism in a liver.

Use

Wet brain, increase of intracranial pressure at renal or a renal liver failure, the epileptic status, a bad attack of glaucoma, operation with extracorporal blood circulation, acute renal (at the kept filtrational function of kidneys) and the liver failure, posttransfusion complications caused by administration of incompatible blood, acute poisonings with barbiturates and other substances (artificial diuresis).

Contraindications

Hypersensitivity, organic lesions of kidneys, disturbance of filtrational function of kidneys, congestive heart failure, hemorrhagic stroke, subarachnoidal hemorrhage (except bleedings during a craniotrypesis), severe forms of dehydration, a hyponatremia, a hypochloraemia, a hypopotassemia, an acute canalicular necrosis.

Restrictions to use

Pregnancy, lactation period.

Side effects

Dehydration (dryness of integuments, a dyspepsia, a myasthenia, spasms, dryness in a mouth, thirst, hallucinations, decrease in the ABP), disturbances of electrolytic balance, tachycardia, pain behind a breast, thrombophlebitis, skin rash.

Interaction

Increase in toxic effect of cardiac glycosides is possible (hypopotassemia).

Route of administration and doses

In/in (slowly struyno or kapelno), in the form of 10 - 20% of solution in a dose of 0,5 - 1,5 g/kg; the daily dose should not exceed 140 - 180 g. The lyophilized weight is dissolved by ex tempore water for injections or 5% dextrose solution. At operations with artificial circulation just before the beginning of perfusion enter 20 - 40 g into the device.