Do Electrolytes Dissolve In Water

What is Mannitol Iv and how is it used?

Mannitol 4 is a prescription medicine used to treat the symptoms of Elevated Intracranial or Intraocular Force per unit area. Mannitol IV may exist used alone or with other medications.

Mannitol IV belongs to a class of drugs called Diuretics, Osmotic Agents.

What are the possible side effects of Mannitol IV?

Mannitol IV may cause serious side furnishings including:

fever,
infection at the injection site,
absorb jell in a deep vein (deep vein thrombosis or DVT),
leakage of intravenously infused medication, and
fluid overload in the blood (hypervolemia)

Become medical assist right abroad, if yous take whatever of the symptoms listed above.

The most common side effects of Mannitol IV include:

headache,
nausea,
diarrhea,
vomiting,
dry out mouth,
thirst,
dehydration,
blurred vision,
runny nose,
arm hurting,
chills,
dizziness,
depression blood pressure (hypotension),
hives,
irregular heartbeat, and
electrolyte imbalance,

Tell the doctor if yous have any side event that bothers yous or that does non go away.

These are not all the possible side effects of Mannitol IV. For more information, ask your doctor or pharmacist.

Call your doctor for medical advice most side effects. You may study side effects to FDA at 1-800-FDA-1088.

DESCRIPTION

Mannitol I.V. (Mannitol Injection, USP) is a sterile, nonpyrogenic solution of mannitol (mannitol (mannitol injection) injection) in h2o for injection available in concentrations of v%, x%, 15%, 20% in flexible plastic containers and 25% in a Fliptop vial for administration by intravenous infusion merely.

The content and characteristics of the bachelor concentrations are as follows:

Conc. (%)	thou/100 mL	mOsmol/liter (calc.)	pH*
v	5	274	six.three (four.5 to vii.0)
x	ten	549	6.3 (four.v to vii.0)
15	xv	823	6.3 (iv.5 to seven.0)
20	twenty	1098	6.3 (4.5 to 7.0)
25	25	1372	5.nine (4.five to seven.0)
*Concentrations upwardly to 20% may contain sodium bicarbonate for pH aligning; the 25% concentration may contain sodium bicarbonate and/or muriatic acid for pH adjustment.

The solutions contain no bacteriostat, antimicrobial agent or added buffer (except for pH adjustment) and each is intended only as a single-dose injection. When smaller doses are required the unused portion should exist discarded.

Mannitol (mannitol (mannitol injection) injection) Injection, USP is a parenteral obligatory osmotic diuretic.

Mannitol, USP is chemically designated D-mannitol (mannitol (mannitol injection) injection) (C_{half dozen}H_xivO_half-dozen), a white crystalline powder or gratuitous-flowing granules freely soluble in water. It has the following structural formula:

Mannitol Structural Formula Illustration

Water for Injection, USP is chemically designated H₂0.

The flexible plastic container is fabricated from a specially formulated polyvinylchloride. Water tin can permeate from inside the container into the overwrap, but not in amounts sufficient to affect the solution significantly. Solutions in contact with the plastic container may leach out certain chemical components from the plastic in very small amounts; however, biological testing was supportive of the prophylactic of the plastic container materials. Exposure to temperatures in a higher place 25°C/77°F during ship and storage will lead to small-scale losses in wet content. Higher temperatures pb to greater losses. Information technology is unlikely that these minor losses volition lead to clinically significant changes within the expiration period.

INDICATIONS

Mannitol I.V. (Mannitol (mannitol (mannitol injection) injection) Injection, USP) is indicated for the post-obit purposes in adults and pediatric patients.

Therapeutic Utilise

Promotion of diuresis in the prevention or treatment of the oliguric phase of acute renal failure earlier irreversible renal failure becomes established.
Reduction of intracranial force per unit area and brain mass.
Reduction of high intraocular pressure when the pressure cannot be lowered by other ways.
Promotion of urinary excretion of toxic materials.

Diagnostic Use

Measurement of glomerular filtration rate.

DOSAGE AND Administration

Mannitol I.Five. (Mannitol (mannitol (mannitol injection) injection) Injection, USP) should be administered only by intravenous infusion. The total dosage, concentration and rate of assistants should be governed by the nature and severity of the status beingness treated, fluid requirement and urinary output. The usual adult dosage ranges from fifty to 200 chiliad in a 24-hour period, but in nearly instances an adequate response volition exist achieved at a dosage of approximately 100 g/24 hours. The rate of administration is normally adjusted to maintain a urine menstruum of at to the lowest degree thirty to 50 mL/hr. The total dose should be adjusted according to the clinical response and adverse events (Run across WARNINGS).

Test Dose: A test dose of mannitol should be given prior to instituting Mannitol (mannitol (mannitol injection) injection) I.V. therapy for patients with marked oliguria or those believed to have inadequate renal role. In adults the dose is 0.ii chiliad/kg body weight. In pediatric patients the dose is 0.2 g/kg body weight or 6 g/yard² body surface area. The infusion is given as a 15% to 25% solution over a period of three to 5 minutes to produce a urine flow of at least thirty to 50 mL/hour. If urine menses does not increase, a second dose may be given; simply if in that location is inadequate response, the patient should be re-evaluated.

Prevention of Astute Renal Failure (Oliguria): When used during cardiovascular or other types of surgery, l to 100 thousand of mannitol (mannitol (mannitol injection) injection) every bit a 5%, 10%, or xv% solution may be given. The concentration volition depend on the fluid requirements of the patient.

Treatment of Oliguria: The usual dose to promote diuresis in oliguric patients: Adults, 300 to 400 mg/kg of body weight (21 to 28 g for a 70 kg patient) or up to 100 one thousand of solution, given as a unmarried dose (often in conjunction with furosemide); pediatric patients, 0.25 to 2 yard/kg body weight or lx g/1000 body surface area as a 15% to xx% solution over a flow of two to 6 hours. Doses should non be repeated in patients with persistent oliguria.

Reduction of Intracranial Pressure and Brain Mass: In adults a dose of 0.25 to two chiliad/kg body weight as a 15% to 25% solution administered over a period of 30 to hr; pediatric patients 1 to 2 one thousand/kg body weight or 30 to 60 yard/one thousand² body surface expanse over a period of 30 to 60 minutes. In small or debilitated patients, a dose of 500 mg/kg may be sufficient. Careful evaluation must exist made of the circulatory and renal reserve prior to and during administration of mannitol (mannitol (mannitol injection) injection) at the higher doses and rapid infusion rates. Conscientious attending must exist paid to fluid and electrolyte balance, torso weight, and total input and output before and subsequently infusion of mannitol (mannitol (mannitol injection) injection) . Evidence of reduced cerebral spinal fluid pressure level must be observed within xv minutes later on starting infusion.

Reduction of Intraocular Pressure: In adults a dose of 0.25 to ii g/kg torso weight every bit a fifteen% to 25% solution administered over a catamenia of 30 to 60 minutes; pediatric patients i to 2 one thousand/kg body weight or 30 to 60 g/yard² body surface expanse over a menses of 30 to 60 minutes. In small or debilitated patients, a dose of 500 mg/kg may be sufficient. When used preoperatively, the dose should be given one to one and one-half hours before surgery to achieve maximal reduction of intraocular pressure before operation.

Adjunctive Therapy for Intoxications: Equally an amanuensis to promote urinary excretion of toxic substances: Adults may receive a 5% to 25% solution for as long as indicated if urinary output remains high; pediatric patients may receive 2 m/kg of torso weight of a 5% or ten% solution. The concentration will depend upon the fluid requirement and urinary output of the patient. If benefits are not observed after 200 thou of mannitol are administered, discontinue the mannitol (mannitol (mannitol injection) injection) therapy. Intravenous water and electrolytes must be given to friction match the loss of these substances in the urine, sweat and expired air.

Measurement of Glomerular Filtration Charge per unit (GFR): 100 mL of a 20% solution (xx g) should exist diluted with 180 mL of sodium chloride injection (normal saline) or 200 mL of a 10% solution (xx g) should be diluted with 80 mL of sodium chloride injection (normal saline). The resulting 280 mL of vii.2% solution is infused at a charge per unit of 20 mL per infinitesimal. The urine is collected by catheter for a specific catamenia of time and analyzed for mannitol (mannitol (mannitol injection) injection) excreted in mg per infinitesimal. A blood sample is drawn at the get-go and at the end of the time period and the concentration of mannitol (mannitol (mannitol injection) injection) determined in mg/mL of plasma. GFR is the number of mL of plasma that must have been filtered to account for the amount excreted per minute in the urine. Normal clearance rates are approximately 125 mL/minute for men; 116 mL/minute for women.

INSTRUCTIONS FOR Employ - Flexible Container

To Open

Tear outer wrap at notch and remove solution container. If supplemental medication is desired, follow directions below earlier preparing for administration. Some opacity of the plastic due to wet assimilation during the sterilization procedure may be observed. This is normal and does non touch the solution quality or safety. The opacity will diminish gradually.

To Add Medication

Ready additive port.
Using aseptic technique and an additive commitment needle of appropriate length, puncture resealable condiment port at target expanse, inner diaphragm and inject. Withdraw needle after injecting medication.
The additive port may be protected by covering with an condiment cap.
Mix container contents thoroughly.

Preparation for Administration (Use aseptic technique)

Close menstruation command clench of administration set up.
Remove cover from outlet port at bottom of container.
Insert piercing pin of administration set into port with a twisting motion until the prepare is firmly seated. NOTE: See full directions on assistants set carton.
Append container from hanger.
Squeeze and release baste sleeping accommodation to establish proper fluid level in bedchamber.
Open up catamenia command clench and clear air from set. Close clamp.
Attach set to venipuncture device. If device is non indwelling, prime number and make venipuncture.
Regulate rate of assistants with menstruum control clamp.

WARNINGS

Practise non employ flexible container in series connections.

INSTRUCTlONS FOR USE - Fliptop Vial

Remove cover and cleanse stopper with antiseptic earlier utilize.

HOW SUPPLIED

Mannitol I.V. (Mannitol (mannitol (mannitol injection) injection) Injection, USP) is supplied in unmarried-dose containers every bit follows:

List No.	Conc.	% Size (mL)
7712	5	k Flexible Container
7713	x	1000 Flexible Container
7714	xv	500 Flexible Container
7715	20	250 Flexible Container
		500 Flexible Container
4031	25	50 Fliptop Vial

NOTE: Crystals may course in mannitol (mannitol (mannitol injection) injection) solutions specially if the solutions are chilled. To dissolve crystals in the flexible container, warm the unit to 70°C with agitation. Heat solution by using a dry-heat chiffonier with overwrap intact. The apply of a water bath is not recommended. To dissolve the crystals in the fliptop vial, warm the bottle in hot water at fourscore°C and periodically shake vigorously. 25% Mannitol (mannitol (mannitol injection) injection) Injection, USP may exist autoclaved at 121°C for 20 minutes at 15 psi. Remove cover from fliptop vial and cleanse stopper with clarified before use. Cool to torso temperature or less before administering. When infusing 20% or 25% mannitol (mannitol (mannitol injection) injection) concentrations, the assistants ready should include a filter.

Exposure of pharmaceutical products to oestrus should be minimized. Avert excessive estrus. Protect from freezing. It is recommended that the flexible containers be stored at room temperature (25°C), however, cursory exposure upwards to 40°C does not adversely affect the product. Store Fliptop vials at controlled room temperature, 15° to 30°C (59° to 86°F). [See USP.]

Hospira Inc., Lake Forest, IL 60045, USA. FDA revision engagement: 11/18/2002

QUESTION

Well-nigh how much does an adult human brain weigh? See Answer

Side Effects & Drug Interactions

SIDE Effects

Adverse reactions more than commonly reported during or afterwards the infusion of mannitol (mannitol (mannitol injection) injection) include: Pulmonary congestion, fluid and electrolyte imbalance, acidosis, electrolyte loss, dryness of oral fissure, thirst, marked diuresis, urinary retention, edema, headache, blurred vision, convulsions, nausea, airsickness, rhinitis, arm pain, skin necrosis, thrombophlebitis, chills, dizziness, urticaria, dehydration, hypotension, tachycardia, fever and angina-like chest pains.

Reactions which may occur considering of the solution or the technique of administration include delirious response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation and hypervolemia.

If an adverse reaction does occur, discontinue the infusion, evaluate the patient, institute appropriate therapeutic countermeasures and save the remainder of the fluid for examination if deemed necessary.

DRUG INTERACTIONS

Additives may exist incompatible. Consult with pharmacist, if available. When introducing additives to the flexible container, utilize aseptic technique, mix thoroughly and practise not store.

Do not place 25% Mannitol (mannitol (mannitol injection) injection) Injection, USP in polyvinylchloride numberless; a white flocculent precipitate may grade from contact with PVC surfaces. Parenteral drug products should exist inspected visually for particulate matter and discoloration; whenever container and solution permit. See PRECAUTIONS.

WARNINGS

In patients with severe impairment of renal function, a test dose should be utilized (encounter DOSAGE AND ADMINISTRATION). A 2nd test dose may be tried if in that location is an inadequate response, only no more than ii test doses should be attempted.
The obligatory diuretic response following rapid infusion of 25% mannitol (mannitol (mannitol injection) injection) may farther aggravate pre-existing hemoconcentration. Excessive loss of water and electrolytes may pb to serious imbalances. Serum sodium and potassium should exist carefully monitored during mannitol (mannitol (mannitol injection) injection) administration.
If urine output continues to decline during mannitol (mannitol (mannitol injection) injection) infusion, the patient'due south clinical status should be closely reviewed and mannitol infusion suspended if necessary. Accumulation of mannitol (mannitol (mannitol injection) injection) may result in overexpansion of the extracellular fluid which may intensify existing or latent congestive heart failure.
Excessive loss of water and electrolytes may pb to serious imbalances. With continued administration of mannitol (mannitol (mannitol injection) injection) , loss of water in excess of electrolytes can crusade hypernatremia. Electrolyte measurements, including sodium and potassium are therefore of vital importance in monitoring the infusion of mannitol (mannitol (mannitol injection) injection) .
Osmotic nephrosis, a reversible vacuolization of the tubules of no known clinical significance, may go along to severe irreversible nephrosis, then that the renal function must exist closely monitored during mannitol infusion.
Mannitol (mannitol (mannitol injection) injection) injection may increase cognitive blood menstruation and the risk of postoperative haemorrhage in neurosurgical patients.
For intravenous use but. Do non administer intramuscularly or subcutaneously. Never add mannitol in whole blood for transfusion.
Mannitol (mannitol (mannitol injection) injection) may increase the cerebral blood flow and worsen intracranial hypertension in children who develop a generalized cerebral hyperemia during the commencement 24 to 48 hours mail service injury.

PRECAUTIONS

The cardiovascular status of the patient should be carefully evaluated before quickly administering mannitol (mannitol (mannitol injection) injection) since sudden expansion of the extracellular fluid may pb to fulminating congestive eye failure.
Shift of sodium-gratis intracellular fluid into the extracellular compartment following mannitol (mannitol (mannitol injection) injection) infusion may lower serum sodium concentration and aggravate pre-existing hyponatremia.
By sustaining diuresis, mannitol (mannitol (mannitol injection) injection) administration may obscure and intensify inadequate hydration or hypovolemia.
Electrolyte-gratuitous mannitol (mannitol (mannitol injection) injection) solutions should non be given conjointly with blood. If information technology is essential that claret exist given simultaneously, at least xx mEq of sodium chloride should be added to each liter of mannitol (mannitol (mannitol injection) injection) solution to avoid pseudoagglutination.
When exposed to depression temperatures, solutions of mannitol (mannitol (mannitol injection) injection) may crystalize. If crystals are observed, the container should be warmed to redissolve, and so cooled to torso temperature before administering. See Annotation under HOW SUPPLIED. When infusing 20% or 25% mannitol (mannitol (mannitol injection) injection) concentrations, the administration prepare should include a filter. Do not infuse mannitol (mannitol (mannitol injection) injection) solution if crystals are present.
Do not administrate unless solution is clear and container is undamaged. Discard unused portion. Do not administrate Mannitol (mannitol (mannitol injection) injection) 25% if the Fliptop vial seal is not intact.

Carcinogenesis, Mutagenesis, Damage of Fertility

Studies with solutions from flexible plastic containers have non been performed to evaluate carcinogenic potential, mutagenic potential or furnishings on fertility.

Pregnancy Category C.

Fauna reproduction studies accept not been conducted with mannitol injection. It is also non known whether mannitol (mannitol (mannitol injection) injection) injection tin cause fetal harm when given to a pregnant woman or can affect reproduction. Mannitol (mannitol (mannitol injection) injection) injection should be given to a pregnant woman only if conspicuously needed.

Nursing Mothers

Caution should be exercised when solutions from flexible plastic containers are administered to a nursing female parent.

Pediatric Use

See DOSAGE AND Administration sections. Rubber and effectiveness of solutions from flexible plastic containers in pediatric patients accept not been well established.

CONTRAINDICATIONS

Well established anuria due to severe renal affliction.
Severe pulmonary congestion or frank pulmonary edema.
Active intracranial haemorrhage except during craniotomy.
Severe dehydration.
Progressive renal impairment or dysfunction subsequently establishment of mannitol (mannitol (mannitol injection) injection) therapy, including increasing oliguria and azotemia.
Progressive centre failure or pulmonary congestion later establishment of mannitol (mannitol (mannitol injection) injection) therapy.
Do not administer to patients with a known hypersensitivity to mannitol.

CLINICAL PHARMACOLOGY

When administered intravenously mannitol (mannitol (mannitol injection) injection) is confined to the extracellular infinite, only slightly metabolized and rapidly excreted by the kidney. Approximately 80% of a 100 g dose appears in the urine in 3 hours. The drug is freely filtered by the glomeruli with less than x% tubular reabsorption; it is non secreted by tubular cells. Mannitol (mannitol (mannitol injection) injection) induces diuresis by elevating the osmolarity of the glomerular filtrate and thereby hindering tubular reabsorption of water. Excretion of sodium and chloride is too enhanced.

PATIENT INFORMATION

No information provided. Please refer to the WARNINGS and PRECAUTIONS sections.

From

FDA Logo

Report Issues to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.