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University of the Philippines Manila

College of Nursing
The Health Sciences Center
Sotejo Hall, Pedro Gil St., Ermita, Manila

Name of Client: ________________________________ Bed number: ___ Ward: _________


Diagnosis: _________________________________________________________________________________
Dosage: __________ Route: ____
Frequency: ________ Time: __________

Mannitol
Osmotic Diuretic

Pharmacologic Actions
● Increases the osmolarity of the glomerular filtrate, which decreases the reabsorption of water and increases
excretion of sodium and chloride.
● It also increases the osmolarity of the plasma, which causes enhanced flow of water from tissues into the
interstitial fluid and plasma. Thus, cerebral edema, increased ICP and CSF volume and pressure are decreased.

Indications
● Diuretic to prevent or threat the oliguric phase of acute renal failure before irreversible renal failure occurs.
● Decrease ICP and cerebral edema by decreasing brain mass.
● Decrease elevated intraocular pressure when the pressure cannot be lowered by other means.
● To promote urinary excretion of toxic substances.
● Investigational: Prevent hemolysis during cardiopulmonary bypass surgery.

Contraindications
Anuria, pulmonary edema, severe dehydration, active intracranial bleeding except during craniotomy, progressive heart
failure or pulmonary congestion after mannitol therapy, progressive renal damage following mannitol therapy.

Adverse Effects
● Most Common: ​Headache, nausea and vomiting, dry mouth, irritation/pain/swelling at injection site
● Electrolyte:​ Fluid and electrolyte imbalance, acidosis, loss of electrolytes, dehydration.
● CV​: hypo/hypertension, edema, increased heart rate, angina-like chest pain, CHF, thrombophlebitis
● CNS​: dizziness, headaches, blurred vision, seizures.

Nursing Considerations
● When used to reduce ICP and brain mass, evaluate circulatory and renal reserve, fluid and electrolyte balance.
● Drug is administered IV in a controlled setting to increase water excretion or to decrease intracranial pressure or
intraocular pressure.
● May experience increased thirst or dry mouth, do not exceed amount of fluid provided
● Report increased SOB or pain in chest, back, legs immediately.

Valenzuela, Ma. Jealyn D.


2008-10169 B.S. Nursing