Name

Frequency/ Dosage / Route

Classification

Mechanism of action

Contraindication

Adverse Reaction

Nursing Responsibility

Generic Name: Osmitrol Brand Name: Resectisol

Adult Oliguria: 50-100 g as a 525% solution. Intracranial/Intraocular pressure: 0.25-2 g/kg as 1525% solution administered for 30-60 minutes. Children Oliguria: 0.25-2 g/kg as a 15-20% solution for 2-6 hours Intracranial/Intraocular pressure: 1-2 g/kg as a 1520% solution administered for 30-60 minutes.

Osmotic Diuretic

*In the oliguric phase of acute renal failure, Mannitol increases 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) and excretes toxic materials (management for toxic overdose). *It also elevates blood plasma osmolality thus, inhibiting the reabsorption of water and electrolytes (for relief of edema) and mobilizing fluids in the cerebral and ocular spaces (lowers intracranial or intraocular pressure).

Half-life 100 minutes Onset 30-60 minutes Peak 1 hour Duration 6-8 hours

*contraindicated with anuria due to severe renal disease *Use cautiously with pulmonary congestion, active intracranial bleeding(except during craniotomy)dehydration, renal disease, CHF

y y y y y y y y y y y y

Dehydration Anuria Intracranial bleeding Headache Blurred vision Nausea and vomiting Volume expansion Chest pain Pulmonaryedema hirst achycardia Hypokalemia (increases the risk of digoxin toxicity) Chronic renal failure

*Observe the IV site regularly for infiltration. *Administration rate for oliguria should be titrated to produce a urine output. (about 30-50 ml/hr in adult and 2-6 hours in children) *do not expose the solution in low temperature because crystalization may occur *tell the relatives that there is a side effect may happen(increase urination, dry mouth and headache)

DOPAMINE

Name

Frequency/ Dosage / Route

Classification

Mechanism of action

Contraindicati on

Adverse Reaction

Nursing Responsibility

Generic Name: Dopamine hydrochloride

autonomic nervous system agent; alphaand beta-adrenergic agonist (sympathomimetic)

Brand Name: Revimine

Naturally occurring neurotransmitter and immediate precursor of norepinephrin. Major cardiovascular effects produced by direct action on alpha- and betaadrenergic receptors and on specific dopaminergic receptors in mesenteric and renal vascular beds.

Contraindicate d with pheochromocy toma, tachyarrhythmi as, ventricular fibrillation, hypovolemia(d opamine is not a substitute for blood, plasma, fluids, electrolytes, which should be restored promptly when loss has occurred)

y y y y y y y y y y y y y

nausea vomiting, tachycardia, ectopic beats, palpitation, anginal pain, hypotension vasoconstricti on bradycardia, hyperten sion, dyspnea headache widened QRS complexes

*Monitor blood pressure, pulse, peripheral pulses, and urinary output at intervals prescribed by physician. Precise measurements are essential for accurate titration of dosage. *Report thefollowing indicators promptly to physician for use in decreasing or temporarily suspending dose: Reduced urine flow rate in absence of hypotension; ascending tachycardia; dysrhythmias; disproportionate rise in diastolic pressure (marked decrease in pulse pressure); signs of peripheral ischemia (pallor, cyanosis, mottling, coldness, complaints of tenderness, pain, numbness, or burning sensation). Monitor therapeutic

effectiveness. In addition to improvement in vital signs and urine flow, other indices of adequate dosage and perfusion of vital organs include loss of pallor, increase in toe temperature, adequacy of nail bed capillary filling, and reversal of confusion or comatose state.