Mannitol

1. Therapeutic Effects
   1. Osmotic agent that acts by increasing the apparent osmolarity of the plasma and urine drawing intracellular fluid and glomerular fluid.

2. Indications
   1. Cerebral edema.
   2. Oliguria and renal failure.
   3. Overdoses and toxic exposures.

3. Contraindications/Precautions
   1. Hypovolemia.
   2. Monitor vital signs and ECG closely.

4. Side Effects
   1. Fluid and electrolyte imbalances are common.
   2. Prerenal azotemia (renal failure).
   3. Chills, chest pain, headache, muscle cramps, seizures.

5. Administration and Dosage
   1. Diuretic: Adult dosage: 50-100 gm. IV over 1-2 hr. Child dosage:2.0 gm/kg over 2-6 hrs. IV
   2. Cerebral edema:Adult dosage: 0.15-2.0 gm/kg as a 15% to 25% solution over 30-60 min. Child dosage:same as adult.
   3. Toxin excretion:Adult dosage:50-200 gm IV/hr to maintain urine flow 100-500 ml/hr. Child Dosage:Up to 2.0 gm/kg IV.