Mannitol
Information from Plumb's Veterinary Drug Handbook, 7th Edition, by Donald C. Plumb:
Mannitol is used to promote diuresis in cases of acute oliguric renal failure, to reduce intraocular and intracerebral pressures, to enhance urinary excretion of certain toxins, and, in conjunction with other diuretics, to rapidly reduce edema or ascites.
Contraindications: Mannitol is contraindicated in patients with anuria secondary to renal disease, severe dehydration, and severe pulmonary congestion or edema. Use with caution when treating ethylene glycol toxicity or other hyperosmolar states, as it can add to intravascular hyperosmolarity. When using for increased CSF pressure, an intact capillary membrane is required. Use should be discontinued if progressive heart failure, pulmonary congestion, progressive renal failure, or renal damage (including increasing oliguria and azotemia) develop after therapy is instituted. Use with caution in hypovolemic patients, as it can enhance hypotension. Mannitol is relatively contraindicated for treating secondary glaucomas, as it may cross the damaged blood aqueous barrier and cause increased IOP.
Adverse effects: Possible adverse effects include fluid or electrolyte imbalances, especially hypernatremia. volume overload, nausea, vomiting, pulmonary edema, CHF, tachycardia, dizziness, headache. Inadvertent overdose can cause excessive excretion of sodium, potassium, and chloride. If urine output is inadequate, water intoxication or pulmonary edema may occur.
The following drugs may interact with mannitol: lithium, sotalol.
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