What is mannitol used for?
(verify) Mannitol is a type of sugar alcohol used as a sweetener and medication. As a sweetener it is used in diabetic food as it is poorly absorbed from the intestines. As a medication, it is used to decrease pressure in the eyes, as in glaucoma, and to lower increased intracranial pressure.
How is the dosage of mannitol determined for glomerular filtration?
Measurement of glomerular filtration rate by creatinine clearance may be useful for determination of dosage. -------------------. It is recommended that 20% Mannitol Injection USP be administered through a blood filter set to ensure against infusion of mannitol crystals.
What is the best approach to administer mannitol to a patient?
An interprofessional team approach is an optimal approach with mannitol administration. It is essential to monitor cardiac function as the fluid shifts can precipitate heart failure. Additional electrolytes, including sodium, potassium, and osmolality, require monitoring by the nurses and physicians.
How is mannitol used to reduce intracranial pressure?
Mannitol for Increased Intracranial Pressure[4] Mannitol may be used for the reduction of intracranial pressure. In this indication, mannitol administration is intravenous. Mannitol then constitutes a new solute in the plasma, which increases the tonicity of the plasma.
Do you use a filter with mannitol?
When infusing 25% mannitol concentrations, the administration set should include a filter. Protect from freezing. Store at 20 to 25°C (68 to 77°F). [See USP Controlled Room Temperature.]
Does mannitol need filter tubing?
Mannitol should be carefully inspected for crystals before it is administered, and it should be administered with an in-line filter, typically 0.22 micron in size.
How do you administer mannitol?
Mannitol should only be given intravenously and never given intramuscularly or subcutaneously. Mannitol should not be administered with whole blood.
How do you keep mannitol from crystallizing?
Mannitol solutions may crystallize when exposed to low temperatures. At higher concentrations, the solutions have a greater tendency to crystallize. Inspect for crystals prior to administration. If crystals are visible, re-dissolve by warming the solution up to 37°C, followed by gentle agitation.
What size filter is used for mannitol?
Table 1.DrugFilter sizeAdministrationMannitolThe manufacturer does not provide a filter size recommendation; 0.2 to 5 µm has been suggested4,112XMethacholine (Provocholine)0.22 µmMogamulizumab-kpkc (Poteligeo)0.22 µmXNivolumab (Opdivo)0.2 to 1.2 µmX69 more rows
In what instances are IV filters required?
Cardiac patients requiring filters In-line filters should be placed on all intravenous lines, central and peripheral, in the following situations: Pre-op (or unrepaired) patients with a congenital heart defect. Patients with single ventricle lesions: pre or post-op. All direct atrial lines.
Does mannitol dissolve in water?
Solubility : Soluble in water (216 mg/ml at 25° C), alcohol (12.05 mg/ml), pyridine, and glycerol (55.56 mg/ml). Insoluble in ether.
Can mannitol be given peripherally?
This hypertonic solution should be administered via a large peripheral or preferably a central vein. Rapid infusion in peripheral veins may be harmful. Mannitol solutions may crystallize when exposed to low temperature.
Does mannitol require a central line?
HTS exceeding 3% should be administered through a central venous catheter owing to the risk of extravasation; however, mannitol may be given via a peripheral IV. Mannitol frequently crystallizes, requiring inspection of the bag or vial for crystals before administration.
At what temperature does mannitol crystallize?
Mannitol crystallization depends strongly on the cooling rate and is initiated during cooling, if the cooling rate is lower than the critical cooling rate; otherwise, mannitol remains amorphous during freezing and crystallizes during subsequent heating above −30 °C.
Can you dilute mannitol?
Note: Diluted solutions of mannitol are less likely to crystallize, especially if the final concentration is less than 15%. An administration set with a filter should be used for infusions containing 20% or more of mannitol. At concentrations of 15% or greater, mannitol may crystallize at low temperatures.
Why is furosemide given after mannitol?
The combination of mannitol and furosemide resulted in greater reduction of brain water content than did mannitol alone. Furosemide enhanced the effect of mannitol on plasma osmolality, resulting in a greater reduction of brain water content.
When do you use a micron filter tubing?
This filtration is intended to protect the patient receiving the medication by filtering out particulate matter, bacteria, and air emboli, protecting the patient from phlebitis due to particulates or infection due to bacteria. Filters are used with the intravenous administration of many medications.
Does all IV tubing have a filter?
When mixing an I.V. medication at home and the tubing doesn't have an in-line filter, it is necessary to connect an add-on filter to the administration tubing. Attaching the add-on filter to the administration tubing: 1.
Why do you need a filter for amiodarone?
Amiodarone is delivered from the pharmacy in a glass intravenous bottle and is administered by using an in-line filter. The filter is required because amiodarone quickly precipitates when mixed with intravenous fluid,9 a characteristic that can be a factor in the development of phlebitis.
What is a 1.2 micron filter used for?
There are two main IV filter pore sizes; the 0.2 micron filter is used for aqueous solutions, and the 1.2 micron filter is recommended for larger molecule solutions such as lipids. The 0.2 micron filter has also been reported to remove air, microorganisms and particulate matter.
How long does it take for mannitol to crystallize?
Dosing: Oliguria: 50 to 100 grams (15 to 25% soln) over 90 minutes to several hours. Test dose may be given: 12.5 g over 3 to 5 min. May repeat. Usual adult dosage ranges (50 to 200 g/ 24hrs). ...
What is the osmotic gradient between blood and cerebrospinal fluid?
An osmotic gradient between the blood and cerebrospinal fluid of approximately 10 mOsmol will yield a satisfactory reduction in intracranial pressure. Adjunctive Therapy for Intoxications. As an agent to promote diuresis in intoxications, mannitol is indicated.
How to protect pharmaceuticals from heat?
Exposure of pharmaceutical products to heat should be minimized. Avoid excessive heat. Protect from freezing. It is recommended that the product be stored at room temperature (25°C).
Does mannitol crystallize?
Note: Diluted solutions of mannitol are less likely to crystallize, especially if the final concentration is less than 15%. An administration set with a filter should be used for infusions containing 20% or more of mannitol. At concentrations of 15% or greater, mannitol may crystallize at low temperatures.
When a hypertonic solution is to be administered peripherally, should it be slowly infused through a small?
When a hypertonic solution is to be administered peripherally, it should be slowly infused through a small bore needle, placed well within the lumen of a large vein to minimize venous irritation. Carefully avoid infiltration.
Do you need to inspect parenteral solution?
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Use of a final filter is recommended during administration of all parenteral solutions, where possible.
What is mannitol used for?
Mannitol is used as a diuretic. Mannitol is used to force urine production in people with acute (sudden) kidney failure. As a diuretic it can be used to treat patients with intractable edema states, to increase urine flow and flush out debris from the renal tubules in patients with acute tubular necrosis, and to increase toxin excretion in patients with barbiturate, salicylate or bromide intoxication 5). Increased urine production helps to keep the kidneys from shutting down, and also speeds up elimination of certain toxic substances in the body.
What causes increased urination?
Osmotic diuresis is increased urination due to the presence of mannitol in the fluid filtered by the kidneys. This fluid eventually becomes urine. Mannitol causes additional water to come into the urine, increasing its amount.
How many capsules of mannitol are in a blister pack?
Aridol is a test kit containing one single patient use inhaler and 3 blister packs containing 19 capsules of mannitol for inhalation in marked doses to perform one bronchial challenge test. It is given by a doctor or other trained health professional who will be with you during the test.
How is mannitol removed?
Mannitol is removed by hemodialysis and peritoneal dialysis. These may be employed in the treatment of mannitol overdose. Eight patients with severe mannitol intoxication were treated.
What is 20% mannitol injection?
20% Mannitol Injection USP (United States Pharmacopeia) treats early kidney failure by increasing urination. This helps your body get rid of extra fluids. 20% Mannitol Injection USP treats brain swelling and increased pressure in the eye. Also treats poisoning by increasing urination to remove toxins from the body.
What is the mechanism of action of mannitol?
The mechanism of action of mannitol is as an osmotic agent 4) . The physiologic effect of mannitol is by means of increased diuresis. Mannitol, when administered intravenously, exerts its osmotic effect as a solute of relatively small molecular size being largely confined to the extracellular space.
What is the purpose of clinical evaluation and periodic laboratory determinations?
Clinical evaluation and periodic laboratory determinations are necessary to monitor changes in fluid balance, electrolyte concentrations, and acid-base balance during parenteral therapy with a mannitol solution.
What happens if you take too much mannitol?
Too rapid infusion of large amounts of mannitol will cause a shift of intracellular water into the extra cellular compartment resulting in cellular dehydration and overexpansion of the intravascular space with hyponatremia, congestive heart failure and pulmonary edema. Repeated doses should not be given to patients with persistent oliguria as this can produce a hyperosmolar state and precipitate congestive heart failure and pulmonary edema due to volume overload. Dosage must be carefully monitored and adjusted in accordance with the clinical situation to avoid the consequences of overdosage (see
How long does it take to reduce intracranial pressure?
Reduction of Intracranial Pressure and Brain Mass: In adults a dose of 0.25 to 2 g/kg body weight as a 15% to 25% solution administered over a period of 30 to 60 minutes; pediatric patients 1 to 2 g/kg body weight or 30 to 60 g/m2 body surface area over a period of 30 to 60 minutes. In small or debilitated patients, a dose of 500 mg/kg may be sufficient. Careful evaluation must be made of the circulatory and renal reserve prior to and during administration of mannitol at the higher doses and rapid infusion rates. Careful attention must be paid to fluid and electrolyte balance, body weight, and total input and output before and after infusion of mannitol. Evidence of reduced cerebral spinal fluid pressure must be observed within 15 minutes after starting infusion.
What is USP in medicine?
Mannitol intravenous (Mannitol Injection, USP) is a sterile, nonpyrogenic solution of mannitol in water for injection available in a concentration of 25% in a fliptop vial for administration by intravenous infusion only.
Can mannitol cause fetal harm?
Animal reproduction studies have not been conducted with mannitol injection. It is also not known whether mannitol injection can cause fetal harm when given to a pregnant woman or can affect reproduction. Mannitol injection should be given to a pregnant woman only if clearly needed.
Can mannitol cause congestive heart failure?
The cardiovascular status of the patient should be carefully evaluated before rapidly administering mannitol since sudden expansion of the extracellular fluid may lead to fulminating congestive heart failure.
What is the mannitol cycle?
A fructose to mannitol metabolic pathway, known as the mannitol cycle in fungi, has been discovered in a type of red algae ( Caloglossa leprieurii ), and it is highly possible that other microorganisms employ similar such pathways.
How is mannitol made?
Mannitol is commonly produced via the hydrogenation of fructose, which is formed from either starch or sucrose (common table sugar). Although starch is a cheaper source than sucrose, the transformation of starch is much more complicated. Eventually, it yields a syrup containing about 42% fructose, 52% glucose, and 6% maltose. Sucrose is simply hydrolyzed into an invert sugar syrup, which contains about 50% fructose. In both cases, the syrups are chromatographically purified to contain 90–95% fructose. The fructose is then hydrogenated over a nickel catalyst into a mixture of isomers sorbitol and mannitol. Yield is typically 50%:50%, although slightly alkaline reaction conditions can slightly increase mannitol yields.
Why is mannitol used in the venous system?
Mannitol can also be used to temporarily encapsulate a sharp object (such as a helix on a lead for an artificial pacemaker) while it passes through the venous system. Because the mannitol dissolves readily in blood, the sharp point becomes exposed at its destination.
What is mannitol salt agar?
Mannitol is the primary ingredient of mannitol salt agar, a bacterial growth medium, and is used in others.
How much mannitol is in seaweed?
Mannitol concentrations of plant exudates can range from 20% in seaweeds to 90% in the plane tree. It is a constituent of saw palmetto ( Serenoa ). Traditionally, mannitol is extracted by the Soxhlet extraction, using ethanol, water, and methanol to steam and then hydrolysis of the crude material.
What is the most abundant energy and carbon storage molecule in nature?
Mannitol is one of the most abundant energy and carbon storage molecules in nature, produced by a plethora of organisms, including bacteria, yeasts, fungi, algae, lichens, and many plants. Fermentation by microorganisms is an alternative to the traditional industrial synthesis.
How long does mannitol last?
As a medication, it is used to decrease pressure in the eyes, as in glaucoma, and to lower increased intracranial pressure. Medically, it is given by injection. Effects typically begin within 15 minutes and last up to 8 hours.
What is mannitol used for?
Continue Reading. Mannitol is an osmotic diuretic that increases urine output. It may be used before cisplatin to reduce the nephrotoxic effects of cisplatin.
How long does mannitol last?
The diuretic effects of mannitol begin approximately 15 to 30 minutes after an infusion, and can last for 2 to 8 hours. Given the duration of action of mannitol, as long as the premedications are administered sufficiently early, administration sequence relative to mannitol does not seem likely to impact clinical outcomes.
