Brand Name:Osmitrol, ResectisolClassification:Osmotic Diuretic

Indications1. Acute oliguric renal failure2. Toxic overdose3. Edema4. Increased intracranial pressure(ICP)5. Intraocular pressure (IOP)Action1. In the oliguric phase ofacute renal failure, Mannitolincreases osmotic pressure(pressure needed to stop the absorption of something or osmosis) of the glumerular filtrate, thereby,promoting diuresis(treating the oliguric phase of renal failure) andexcretes toxic materials(management for toxic overdose).2. It also elevatesblood plasmaosmolality thus,inhibiting the reabsorption of water and electrolytes(for relief of edema) andmobilizing fluids in the cerebral and ocular spaces(lowers intracranial or intraocular pressure).Contraindications1. Susceptibility2. DehydrationAdverse reactions1. Dehydration2. Anuria3. Intracranial bleeding4. Headache5. Blurred vision6. Nausea and vomiting7. Volume expansion8. Chest pain9. Pulmonary edema10. Thirst11. Tachycardia12. Hypokalemia (increases the risk of digoxin toxicity)13. Chronic renal failureDosageAdultOliguria: 50-100 g as a 5-25% solution.Intracranial/Intraocular pressure: 0.25-2 g/kg as 15-25% solution administered for 30-60 minutes.ChildrenOliguria: 0.25-2 g/kg as a 15-20% solution for 2-6 hoursIntracranial/Intraocular pressure: 1-2 g/kg as a 15-20% solution administered for 30-60 minutes.Nursing considerationsAssessmentMonitor the following:1. 1.Vital signs2. 2.Intake and output3. 3.Central venous pressure4. Pulmonary artery pressure5. Signs and symptoms of dehydration (e.g. poor skin turgor, dry skin, fever, thirst)6. Signs of electrolyte imbalance/deficit (e.g. muscular weakness, paresthesia, numbness, confusion, tingling sensation of extremity and excessive thirst)7. (for increase ICP) Neurologic status and intracranial pressure readings.8. (for increase IOP) Elevating eye pain or decreased visual acuity.