Mannitol infusion 20% Fresenius Kab Preventing acute kidney necrosis due to hypotension, underwear (250ml)

Dosage form Bottle
Specifications Mannitol

Ingredient

Composition information	Content
Mannitol	20%

Uses

indications

20% mannitol drug is indicated in the following cases:

Acute kidney necrosis prevention due to hypotension.

used as washing in the prostate endoscopy. After injecting into the vein, manitol is distributed into the macronal compartment. Therefore, manitol has the effect of increasing the permeability of plasma and fluid in the renal tubules, causing osmosis and increased kidney blood flow. The effect of manitol is stronger than the dextrose (because it is less metabolized in the body and less reabsorbed by the renal tubules). Although it must be used in large volumes, manitol is less likely to cause side effects than urea, but it is equal.

Manitol is mainly used by intravenous line to gain osmosis to protect kidney function in acute renal failure; To reduce intracranial pressure and reduce eyeball. Manitol is used to cause pressure on the handling of drug overdose. Do not use manitol in heart failure because of the sudden increase in blood volume. Using highitol high doses to treat cerebral edema can change the volume, osmotic and extracellular fluid to the extent that in some cases, it can lead to acute renal failure, loss of heart failure and many other complications. Intrasperized manitol is also used in cardiovascular surgery, in many other types of surgery or after trauma.

manitol is a drug that reduces the pressure of eyeball, short -term intracranial pressure. The effect of reducing eyeball and intracranial pressure appears within 15 minutes after the start of manitol transmission and lasts from 3 to 8 hours after stopping the transmission; The diuretic effects appear after transmission from 1 to 3 hours.

manitol is an osmotic bleach if used by oral and causing diarrhea.

Manitol may also reduce blood viscosity, increase the deformation of red blood cells and increase arterial blood pressure.

pharmacokinetics

manitol is less valuable in terms of energy because it is much eliminated from the body before being metabolized. Manitol is less metabolized in the body (only 7-10%); Most eliminated through the urine in the form of intact along with the corresponding amount of water. If drinking, about 17% is absorbed. Intravenous injection of 1g/kg and 2 g/kg causes the increased osmosis of the serum, equivalent to 11 and 32 mosms, causing the serum sodium concentration to decrease, respectively, 8.7 and 20.7 mmol/liter, and the reduced hemoglobin respectively is 2.2 and 2.5 g/decompite. The volume of VD distribution is 0.2333 liters/kg; The clearance is 0.086 liters/hour/kg. Half life eliminates about 100 minutes (with normal kidney function). When the kidneys are impaired, the manitol is accumulated and causes the water to turn into the pulse, leading to dehydration in the cell and hypoglycemia.

Before taking Mannitol infusion 20% Fresenius Kab Preventing acute kidney necrosis due to hypotension, underwear (250ml)

How to use

Intravenous infusion.

Dosage

adults

Test:

intravenous infusion of 200 mg/kg body weight or 12.5 g of 15% or 25% manitol solution, for 3 to 5 minutes, will cause urine output at least 30 to 50 ml per hour for 2 to 3 hours later. If responded to the first time is not good, the second test can be redone. If the urine flow is 2-3 hours after testing less than 30-50 ml/hour, the kidney will be damaged (no manitol is not used in this case).

Prevention of acute renal failure:

Test as the usual adult dose for 50 to 100 g of intravenous injection with a solution of 5 to 25%. The transmission speed is usually adjusted to have 1 urine flow at least 30 to 50 ml/hour.

To increase the elimination of toxins:

Test as above uses the urine flow at least 100 ml/hour, usually maintaining 500 ml/hour and positive balance of up to 1-2 liter.

To reduce the toxicity of cisplatin on the kidney:

Quick transmission 12.5 g right before using cisplatin, then transmission 10 g/hour, for 6 hours using 20%solution. Compensation with solution with sodium chloride 0.45%, potassium chloride 20 - 30 MEQ/liter at a speed of 250 ml/hour, for 6 hours. Maintain urine flow above 100 ml/hour by infusion of manitol.

Reduce intracranial pressure:

Quick intravenous intravenous solution of 15% to 25%, at a dose of 1 to 2 g/kg, within 30 to 60 minutes. If the barrier - the brain is not intact, the manitol transmission can lead to increased intracranial pressure (this case should use Furosemid).

Reducing eyeball pressure:

The dose of 1.5 to 2 g/kg, transmitted for 30-60 minutes with a solution of 15 - 20%. The effect appears within 15 minutes from the beginning of manitol transmission and lasts from 3 to 8 hours after stopping. Manitol's effects can be evaluated on intracranial pressure and eye pressure by examining the eyes of the patient (the situation of thorns, stagnation), monitoring clinical symptoms. Dose adjustment, epidemic concentration and transmission speed according to the level of the patient's response.

Used in prostate surgery through the urethra:

Manitol solution from 2.5% to 5% is used to water, wash the bladder during prostate surgery through the urethra.

Dosage in pediatrics

Urusoline or urinary treatment:

Test at a dose of 200 mg/kg as above; Treatment dose is 2g/kg intravenously solution 15 - 20% for 2 - 6 hours.

To reduce intracranial pressure or eyeball pressure:

Dosage 2 g/kg, transmitted for 30 - 60 minutes use solution 15 - 25%.

Poisoning treatment:

2 g/kg, transmitting solution 5 - 10% so that it can maintain a large urine flow.

Elderly

Start with the lowest initial dose and adjust according to the response.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What do

do when overdose? Symptomatic treatment.

What to do when forgetting 1 dose?

Not recorded.

Side Effects

When using 20%mannitol medicine, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Circulation: Increasing cellular volume, cycle overload (when using high doses), Venous inflammation.

Systemic: Roll, fever, headache. Digestive: Nausea, vomiting, thirst, diarrhea (when used by oral, manitol works like bleach).

Metabolism: Water and electrolyte imbalance, alkaline imbalance

Muscle muscle: chest.

Eyes: blurred vision.

Rare, ADR

On the spot: The drug can cause edema and necrosis.

circulating: tachycardia.

kidneys: kidney damage to each nest due to absorbing, acute renal failure (when taking high doses).

allergic reaction: urticaria, anaphylaxis, dizziness.

Instructions on how to handle ADR

Need to monitor patients closely during manitol infusion and must be slowed.

Must slow down the transmission speed if the patient calls for headaches, nausea ...

Preventing intestinal breakage during colon scan by pumping and suctioning colon steam during screening.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

20% Mannitol drugs contraindicated in the following cases:

Dehydration.

Server congestive heart failure, severe heart diseases.

pulmonary edema, pulmonary congestion.

intracranial bleeding after a traumatic brain injury (except during the surgery to open the skull).

The metabolic disorders are accompanied by fragile capillary.

Severe renal failure (except for the response to the test of diuretic benefits; if there is no response or poor response, the increased extracellular volume may lead to acute water poisoning).

Digns or anuria after testing with manitol.

Be cautious when using

before use must be sure that the patient is not dehydrated.

During the transmission, it is necessary to closely monitor the fluid and electrolyte balance, the permeability of plasma, kidney function, signs of survival.

If the fluid flow is more than urine flow, it can cause water poisoning. The prolonged diuretic effect of the drug can cover the signs of insufficient water rehydration or reduce the volume of circulation.

Venous lines need to match the attached filter.

Do not transmit manitol along with total blood.

Before transmission, check the compatibility of the substances to add to the manitol solution.

Due to hypertonic fluid, only the injecting manitol solution into the vein, otherwise, can cause tissue necrosis.

manitol (especially oral use) can increase the concentration of hydrogen gases in the large intestine to the point of causing intestinal breakage when therapy with therapy (diaterny).

The ability to drive and operate machinery

Not recorded.

Pregnancy

Manitol is safe for pregnant women.

Breastfeeding period

No data.

Interactive drug

Patients who are being treated with lithium need to be monitored with drugs when using manitol.

Cavalry: Do not transmit manitol along with total blood.

Storage

Store at room temperature from 15 - 30oC. Avoid freezing.

can form crystals in solutions containing over 15% manitol, especially when stored at low temperatures. Soak the bottle in warm water, causing the crystals to dissolve again.

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