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why is mannitol administered through a filter

by Morton Greenholt Published 3 years ago Updated 2 years ago

Why is mannitol given through a filter? The drug is freely filtered by the glomeruli with less than 10% tubular reabsorption; it is not secreted by tubular cells. Mannitol induces diuresis by elevating the osmolarity of the glomerular filtrate and thereby hindering tubular reabsorption of water. Excretion of sodium and chloride is also enhanced.

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.Sep 3, 2017

Full Answer

What are the FDA-approved uses of mannitol?

Mannitol has four Food and Drug Administration (FDA)-approved uses. [1][2][3][4] Mannitol has approval for the reduction of intracranial pressure and brain mass. Mannitol is approved to reduce intraocular pressure if this is not achievable by other means.

How is mannitol excreted from the body?

Mannitol is filtered by the glomeruli, exhibits less than 10% of tubular reabsorption, and is not secreted by tubular cells. Following intravenous administration, approximately 80% of an administered dose of mannitol is estimated to be excreted in the urine in three hours with lesser amounts thereafter.

How is mannitol injection supplied?

How is Mannitol Injection Supplied. Mannitol Intravenous (Mannitol Injection, USP) is supplied in single-dose containers as follows: NOTE: Crystals may form in mannitol solutions especially if the solutions are chilled. To dissolve crystals in the flexible container, warm the unit to 70°C with agitation.

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.

Do you have to use a filter with mannitol?

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?

The recommended dosage is 1.5 to 2 g/kg as a single dose administered as an intravenous infusion over at least 30 minutes. When used preoperatively, administer Mannitol Injection 60 to 90 minutes before surgery to achieve maximal reduction of intraocular pressure before operation.

How do you keep mannitol from crystallizing?

It should be noted that Mannitol solutions may crystallize when exposed to low temperature. At higher concentrations, the solutions have a greater tendency to crystallize. To prevent crystallization of Mannitol solution, healthcare workers are advised to strictly store the product at room temperature (20°C to 30°C).

What are nursing administration considerations for mannitol?

Nursing care of the patient receiving mannitol requires vigilant monitoring of electrolytes and overall fluid balance, and observation for the development of cardiopulmonary complications in addition to neurologic assessment.

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.

Why is mannitol given IV bolus?

Mannitol to Promote Diuresis in Acute Renal Failure Fluid overload causes issues such as decreased oxygenation and ventilation, electrolyte abnormalities, swelling, encephalopathy, and cardiac arrest. An individual with acute renal failure can sometimes be given intravenous mannitol.

How fast can you infuse mannitol?

The usual dose is 1.5 to 2 g/kg bw (10 to 13 ml/kg bw), infused over 30 to 60 minutes. When used preoperatively, the dose should be administered 1 to 1.5 hours before surgery to obtain the maximum effect. In forced diuresis the dose of mannitol should be adjusted to maintain urinary output of at least 100 ml/hour.

Is mannitol water soluble?

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 you push mannitol?

Mannitol Intravenous (Mannitol Injection, USP) should be administered only by intravenous infusion. The total dosage, concentration and rate of administration should be governed by the nature and severity of the condition being treated, fluid requirement and urinary output.

When administering mannitol for raised ICP Which one of the following lab tests is the priority?

When administering mannitol for raised ICP, which one of the following lab tests is the priority? Rationale for Correct Response: d) Mannitol is given to promote osmotic diuresis and reduce cerebral edema. Repeated dosing can cause excessive volume contraction.

How does mannitol cause hypernatremia?

Mannitol is freely filtered by the glomerulus and does not undergo tubular reabsorption. Thus, it acts as an osmotic diuretic, increasing urinary loss of both sodium and electrolyte-free water. Lack of replacement of the fluid loss can lead to both volume depletion and severe hypernatremia.

Mannitol Injection Description

20% Mannitol Injection USP is a sterile, nonpyrogenic solution of Mannitol USP in a single dose container for intravenous administration. It contai...

Mannitol Injection - Clinical Pharmacology

Mannitol Injection USP is one of the nonelectrolyte, obligatory, osmotic diuretics. It is freely filterable at the renal glomerulus, only poorly re...

Indications and Usage For Mannitol Injection

20% Mannitol Injection USP is indicated for:Promotion of diuresis, in the prevention and/or treatment of the oliguric phase of acute renal failure...

Mannitol Injection Dosage and Administration

This solution is for intravenous use only.The total dosage, concentration, and rate of administration should be governed by the nature and severity...

How Is Mannitol Injection Supplied

20% Mannitol Injection USP is supplied sterile and nonpyrogenic in EXCEL® Containers. The 500 mL and 250 mL containers are packaged 24 per case.Exp...

Directions For Use of Excel® Container

Do not admix with other drugs.Caution: Do not use plastic containers in series connection.To OpenTear overwrap and remove solution container. Check...

Principal Display Panel - 500 Ml Container Label

20% MannitolInjection USPREF L5781NDC 0264-7578-10HK 22605500 mLEXCEL® CONTAINEREach 100 mL contains: Mannitol USP 20 g; Water for Injection USP qs...

Principal Display Panel - 250 Ml Container Label

20% MannitolInjection USPREF L5782NDC 0264-7578-20HK 22605250 mL EXCEL® ContainerEach 100 mL contains: Mannitol USP 20 g;Water for Injection USP qs...

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). ...

How much mannitol should I give for oliguria?

If response is inadequate, the patient should be reevaluated. When used during cardiovascular and other types of surgery, 50 to 100 g of mannitol may be given. The usual dose for treatment of oliguria is 100 g administered as a 20% solution.

Does mannitol crystallize at low temperatures?

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. Dosing:

2 DOSAGE AND ADMINISTRATION

Mannitol Injection is for intravenous infusion preferably through a central venous catheter [see Warnings and Precautions (5.6), Description (11)].

2 DOSAGE AND ADMINISTRATION

Mannitol Injection is for intravenous infusion preferably through a central venous...

3 DOSAGE FORMS AND STRENGTHS

Mannitol Injection 25%, USP: 12.5 g/50 mL (0.25 g/mL) of mannitol as a clear and colorless solution in a single-dose vial.

6 ADVERSE REACTIONS

The following adverse reactions associated with the use mannitol were identified in clinical studies or postmarketing reports. Because some of these reactions were reported voluntarily from a population...

7 DRUG INTERACTIONS

Concomitant administration of nephrotoxic drugs (e.g., cyclosporine, aminoglycosides) increases the risk of renal...

10 OVERDOSAGE

Signs and symptoms of overdose with Mannitol Injection include renal failure and acute kidney injury, hypo/hypervolemia, hyperosmolarity and electrolyte imbalances, CNS toxicity (e.g., coma, seizures), some of...

11 DESCRIPTION

Mannitol Injection, USP is a sterile, nonpyrogenic solution of mannitol in water for injection available in a fliptop vial for intravenous administration as an osmotic diuretic.

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

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.

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.

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