Mindanao State University – Iligan Institute of Technology Student: _________________________ Section:___________

PHARMACOLOGY

DRUG STUDY

Brand Name: Osmitrol________________________________ Generic Name: Mannitol_______________ Drug Classification: Carbonic Anhydrase Inhibitor

Dosage, Route & Frequency Drug-Drug & Drug- Side Effects Adverse Reactions
Drug Action Indications Contraindications
Recommended Prescribed Food Interactions (By System) (By System)
Cerebral Edema Increases the osmotic Hypokalemia The promotion of ● Well established Angina-like chest CNS:confusion,
Reduction of intracranial pressure of the glomerular increase the risk of diuresis, in the anuria due to severe pains headache.
pressure and treatment of filtrate, thereby inhibiting digoxin toxicity prevention and/or renal disease, Congestive heart EENT: blurred vision,
cerebral edema reabsorption of water and treatment of the ● Severe pulmonary
failure rhinitis.
1.5-2 g/kg IV infused over electrolytes. Causes excretion Additives may be oliguric phase of congestion or frank
30-60 minutes of: Water, Sodium, Potassium, acute renal failure pulmonary edema, Low blood pressure CV: transient volume
incompatible. When (hypotension) expansion, chest
Reduction of Intracranial Chloride, Calcium, before irreversible ● Active intracranial
Pressure Phosphorus, Magnesium, introducing renal failure becomes bleeding except Phlebitis pain, HF, pulmonary
0.25 g/kg/dose infused IV Urea, Uric acid. additives to the established; The during craniotomy, Convulsions edema, tachycardia.
over 30 minutes, may repeat Therapeutic Effects: flexible container, reduction of ● Severe dehydration, Chills GI: nausea, thirst,
q6-8hr Mobilization of excess fluid in use aseptic intracranial pressure ● Progressive renal Dizziness vomiting.
oliguric renal failure or edema. technique, mix and treatment of damage or
Reduction of Intraocular Headache GU: renal failure,
Reduction of intraocular or thoroughly and do cerebral edema by dysfunction after
Pressure intracranial pressure. reducing brain mass; institution of mannitol Acidosis urinary retention.
1.5-2 g/kg IV infused over not store. Fluid/electrolyte F and E: dehydration,
Increased urinary excretion of The reduction of therapy,
30-60 minutes toxic materials. Decreased elevated intraocular ● increasing oliguria imbalances hyperkalemia,
When used preoperatively, hemolysis when used as an pressure when the and azotemia Thirst hypernatremia,
administer 1-1.5hr before irrigant after transurethral pressure cannot be ● Progressive heart Nausea hypokalemia,
surgery for maximal prostatic resection. lowered by other failure or pulmonary Vomiting hyponatremia.
reduction of IP before means, and congestion after
operation Pharmacokinetics Blurred vision Local: phlebitis at IV
promoting the urinary institution of mannitol
Anuria/Oliguria Absorption: IV administration excretion of toxic therapy Urinary retention site.
Test dose: 200 mg/kg IV produces complete substances. Runny nose
infused over 3-5 minutes bioavailability. Some Skin rash
Load: 500-1000 mg/kg IV x1 absorption may follow use as Hives
dose a GU irritant.
High blood
Maintenance: 250-500 mg/kg Distribution: Confined to the
IV q4-6hr extracellular space; does not pressure
usually cross the blood-brain (hypertension)
barrier or eye. Fever
Metabolism and Excretion:
Excreted by the kidneys;
 minimal liver metabolism.
Half-life: 100 min.

Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)
Assessment Implementation
● Monitor vital signs, urine output, CVP, and pulmonary artery pressures (PAP) before and hourly ● Observe infusion site frequently for infiltration. Extravasation may cause tissue irritation and
throughout administration. Assess patient for signs and symptoms of dehydration (decreased skin necrosis.
● Do not administer electrolyte-free mannitol solution with blood. If blood must be
turgor, fever, dry skin and mucous membranes, thirst) or signs of fluid overload (increased CVP,
administered simultaneously with mannitol, add at least 20 mEq NaCl to each liter of
dyspnea, rales/crackles, edema). mannitol.
● Assess patient for anorexia, muscle weakness, numbness, tingling, paresthesia, confusion, and ● Confer with physician regarding placement of an indwelling Foley catheter (except when
excessive thirst. Report signs of electrolyte imbalance. used to decrease intraocular pressure).
● Increased Intracranial Pressure: Monitor neurologic status and intracranial pressure readings in
patients receiving this medication to decrease cerebral edema. Patient/Family Teaching
● Increased Intraocular Pressure: Monitor for persistent or increased eye pain or decreased visual ● Explain purpose of therapy to patient.
acuity.
Evaluation/Desired Outcomes
● Lab Test Considerations: Renal function and serum electrolytes should be monitored routinely
● Urine output of at least 30– 50 mL/hr or an increase in urine output in accordance with
throughout course of therapy.
parameters set by physician.
Potential Nursing Diagnoses ● Reduction in intracranial pressure.
● Excess fluid volume (Indications) ● Reduction of intraocular pressure.
● Risk for deficient fluid volume (Side Effects) ● Excretion of certain toxic substances.
● Irrigation during transurethral prostate resection

References:

https://reference.medscape.com/drug/osmitrol-mannitol-343061
https://www.rxlist.com/mannitol-iv-drug.htm#warnings
https://www.rxlist.com/consumer_mannitol_osmitrol/drugs-condition.htm
https://davisplus.fadavis.com/3976/meddeck/pdf/mannitol.pdf
https://www.accessdata.fda.gov/drugsatfda_docs/label/2005/013684s091lbl.pdf