Mannitol: Half-Life Onset Peak Duration

Mannitol
Brand Name: Osmitrol, Resectisol
Classification: Osmotic Diuretic
General description
Mannitol is an Osmotic diuretic agent. It is osmotically active agent and promotes a water diuresis. It is
weak diuretic agent. It is widely used as IV administration for prompt action and diuresis occurs 1-3 hrs
after administration. It is pregnancy category C drug.
Mechanism of action
The pct and descending limb of loop of henle is highly permeable to water. Mannitol is filtered through the
glomerulus but not reabsorbed thus increase the solute concentration within the tubule. According to the
rule of osmosis when solute concentration increases in the lumen then water flow from low concentration
of solute (blood vessels) to high concentration of solute (lumen) thus water retain within the lumen and does
not reabsorb from lumen and cause diuresis.
Pharmacokinetics:
Mannitol is poorly absorbed thus, it must be administered parenterally. If given orally, mannitol caused osmotic
diarrhea. Mannitol is not metabolized. It is excreted by the glomerulus filtration after 30-60 mins of
administration.
Action Summary
Half-life Onset Peak Duration
100 minutes 30-60 minutes 1 hour 6-8 hours
Indications
1. Acute oliguric renal failure
2. Toxic overdose
3. Edema
4. Increased intracranial pressure (ICP)
5. Intraocular pressure (IOP)
6. Cerebral Oedema
7. Intraocular pressure
8. Oligria/Anuria
Action
1. In the oliguric phase of acute renal failure, Mannitol increases osmotic pressure (pressure needed to
stop the absorption of something or osmosis) of the glumerular filtrate, thereby, promoting
diuresis(treating the oliguric phase of renal failure) and excretes toxic materials (management for
toxic overdose).
2. It also elevates blood plasma osmolality thus, inhibiting the reabsorption of water and
electrolytes(for relief of edema) and mobilizing fluids in the cerebral and ocular spaces (lowers
intracranial or intraocular pressure).
Contraindications
1. Susceptibility
2. Dehydration
3. Patient with severe dehydration
4. Hypersensitivity
5. Heart Failure
6. Anuria
7. Active cerebral hemorrhage (who undergoes craniotomy)
Adverse reactions
1. Dehydration
2. Anuria
3. Intracranial bleeding
4. Headache
5. Blurred vision
6. Nausea and vomiting
7. Volume expansion
8. Chest pain
9. Pulmonary edema
10. Thirst
11. Tachycardia
12. Hypokalemia (increases the risk of digoxin toxicity)
13. Chronic renal failure
Dosage
Adult
Oliguria: 50-100 g as a 5-25% solution.
Intracranial/Intraocular pressure: 0.25-2 g/kg as 15-25% solution administered for 30-60 minutes.
Children
Oliguria: 0.25-2 g/kg as a 15-20% solution for 2-6 hours
Intracranial/Intraocular pressure: 1-2 g/kg as a 15-20% solution administered for 30-60 minutes.
Nursing considerations
Assessment – Monitor the following:

1. 1. Vital signs
2. 2. Intake and output
3. 3. Central venous pressure
4. Pulmonary artery pressure
5. Signs and symptoms of dehydration (e.g. poor skin turgor, dry skin, fever, thirst)
6. Signs of electrolyte imbalance/deficit (e.g. muscular weakness, paresthesia, numbness, confusion,
tingling sensation of extremity and excessive thirst)
7. (for increase ICP) Neurologic status and intracranial pressure readings.
8. (for increase IOP) Elevating eye pain or decreased visual acuity.
Laboratory Tests
1. Renal function (BUN and Creatinine)

2. Serum Electrolyte (Sodium and Potassium)
Precaution
Pregnancy and lactation (safe use during these conditionsis not established)
Interventions
1. Observe the IV site regularly for infiltration.

2. Administration rate for oliguria should be titrated to produce a urine output. (about 30-50 ml/hr in adult
and 2-6 hours in children)
Patient education for patients under osmotic diuretics
• Explain the right use of diuretics with dosage

• Report any visible s/s of proximal edema, SOB, potential sign of Heart Failure or Pulmonary edema
• Report immediate if feeling dizzy or change in consciousness
• Advise them to change position slowly to avoid postural hypotension
• Monitor BP as specified by the HP
• Do not breastfeed while taking the drug
• Mention possible side effects that can cause by the use of diuretics such as dry mouth, increase in
urination.

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Mannitol

Brand Name: Osmitrol, Resectisol

Classification: Osmotic Diuretic

Half-life Onset Peak Duration

100 minutes 30-60 minutes 1 hour 6-8 hours

Assessment – Monitor the following:

1. Renal function (BUN and Creatinine)

1. Observe the IV site regularly for infiltration.

Patient education for patients under osmotic diuretics

• Explain the right use of diuretics with dosage

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