NAME Generic: Mannitol Brand: Osmitrol, Resectisol

CLASSIFICATION Therapeutic: Diuretics Pharmacologic: Osmotic diuretic

MECHANISM OF ACTION  Increases the osmotic pressure of the glomerular filtrate, thereby inhibiting reabsorption of water and electrolytes.  Causes excretion of: water, sodium, potassium, chloride, calcium, phosphorus, magnesium, urea, uric acid Therapeutic effects:  Mobilization of excess fluid in oliguric renal failure or edema.  Reduction of intraocular or intracranial pressure.  Increased urinary excretion of toxic materials.  Decreased hemolysis when used as an irrigant after transurethral prostatic resection

INDICATIONS Adjunct in the treatment of:  Acute oliguric renal failure  Edema  Increased intracranial or intraocular pressure  Toxic overdose

SIDE EFFECTS CNS: Confusion, headache EENT: Blurred vision, Rhinitis CV: Transient volume expansion, Chest pain, CHF, pulmonary edema, tachycardia GI: Nausea, thirst, vomiting GU: renal failure, urinary retention F&E: Dehydration, hyperkalemia, hypernatremia,hypok alemia, hyponatremia Local: Phlebitis@ IV site

NURSING RESPONSIBILITIES Before:  Check vital signs and urine output.  Assess signs of dehydration and muscle weakness  Monitor neurologic status and intracranial pressure

 Hypersensitivity  Anuria  Dehydration  Active Intracranial bleeding  Use cautiously in:  Pregnany & lactaion

During:  Administer over 30min  Monitor urine output and refer in accordance with parameters set by physician  Ensure safety and report signs of electrolyte imbalance

After  Check effectiveness of therapy  Continuously monitor neurologic status and urine output  Reassess signs/symptoms of dehydration  Watch out for abnormal responses