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Mannitol
💡 Mannitol is an osmotic diuretic mainly used in emergencies such as raised intracranial or intraocular pressure. It creates an osmotic gradient, pulling water out of tissues (e.g. brain, eye) into the intravascular space, where it can then be excreted via the kidneys.
🧾 About: Always check the BNF link here
- Osmotic diuretic – does not cross intact cell membranes.
- Used in neurosurgical and ophthalmic emergencies.
⚙️ Mode of Action
- Increases plasma osmolality → draws fluid out of brain/eye tissues.
- Filtered by the kidney but not reabsorbed → osmotic diuresis.
- Reduces intracranial pressure (ICP) and intraocular pressure (IOP).
💊 Indications & Dosing (verify with BNF/datasheet)
- 🧠 Cerebral oedema / Raised ICP: Mannitol 20% solution, 1 g/kg IV infusion over 30–60 minutes.
- ♻️ Dose can be repeated 1–2 times after 4–8 hours if needed.
- 👁️ Raised intraocular pressure (acute glaucoma): similar dosing regimen.
🔄 Interactions
- See BNF for full list.
⚠️ Cautions
- For Mannitol 20%, use an in-line filter (15-micron filters commonly used) → prevents crystallisation particles entering patient.
- Monitor renal function, electrolytes, and fluid balance closely.
⛔ Contraindications
- Severe left ventricular failure (LVF) or pulmonary oedema.
- Severe dehydration.
- Active intracranial bleeding (unless during craniotomy).
💥 Side Effects
- Polyuria / diuresis, dehydration, electrolyte disturbances (↓Na⁺, ↓K⁺).
- Headache, dizziness, blurred vision.
- Hypotension, tachycardia.
- GI upset: nausea, vomiting, diarrhoea, dry mouth, thirst.
- Allergic reactions: rash, urticaria, chills.
- Local: pain, irritation, or swelling at injection site.
📚 References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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