MANITOL DAN GLISERIN

GOLONGAN HIPEROSMOTIK

meningkatkan cairan berpindah

tekanan osmotik dari mata ke
plasma gradien osmotik plasma penurunan TIO
dibanding struktur pembuluh darah
intraokular mata yang
hiperosmotik
 INDIKASI

• MENURUNKAN TIO DALAM JANGKA PENDEK

• KEADAAN DARURAT : GLAUKOMA SUDUT TERTUTUP AKUT
• KONTROL PENINGKATAN TIO PRE-OPERATIF
GLYCERIN

• GLYCEROL (GLYCERIN) IS A TRIVALENT ALCOHOL READILY ABSORBED WHEN GIVEN

ORALLY
AND CHIEFLY CONVERTED TO GLUCOSE, GLYCOGEN AND OTHER CARBOHYDRATES IN
THE LIVER

• A TOPICAL DEHYDRATING AGENT FOR CLEARING EDEMATOUS CORNEAS

• WATER SOLUBLE AND HAS A SWEET TASTE

• GLYCEROL HAS BEEN FOUND TO BE EASILY TOLERATED ON ORAL USE WITHOUT ANY
SIDE-EFFECTS OR TOXIC SYMPTOMS.
• DOSE : 1-2 G/KG/DOSE ORALLY, REPEAT EVERY 5 HOURS WHEN REQUIRED
• CAMPUR DENGAN MINUMAN RASA JERUK (1:1.5)
• LANGSUNG MINUM SEMUA
MANNITOL

• HYPEROSMOTIC AGENT
• MODE OF ACTION
• INCREASES PLASMA OSMOLALITY; DEHYDRATES VITREOUS BODY. PRODUCES A
RAPID (30 MINUTES) BUT TEMPORARY (6 HOURS) DROP IN INTRAOCULAR
PRESSURE.

• INDICATIONS
• ACUTE CLOSED-ANGLE GLAUCOMA UNRESPONSIVE TO CONVENTIONAL
TREATMENT

• INTRAOCULAR PRESSURE REDUCTION BEFORE INTRAOCULAR SURGERY

(PREVENTS PROLAPSE OF INTRAOCULAR CONTENTS)
MANNITOL

• ADVERSE EFFECTS
• ADVERSE EFFECTS ARE GENERALLY INFREQUENT
• FLUID AND/OR ELECTROLYTE SHIFT CAN PRODUCE PULMONARY CONGESTION,
ACIDOSIS, ELECTROLYTE LOSS, DRY MOUTH, THIRST, OEDEMA, HEADACHE,
BLURRED VISION, SEIZURES AND HEART FAILURE.

• NAUSEA, VOMITING, LOCAL PAIN, SKIN NECROSIS AND THROMBOPHLEBITIS

(INJECTION SITE), CHILLS, DIZZINESS, URTICARIA, HYPOTENSION, TACHYCARDIA,
FEVER, ANGINA-LIKE CHEST PAINS

• DOSAGE – MANNITOL
• ADULT, IV 1–2 G/KG (5–10 ML/KG OF 20% SOLUTION) OVER 30 MINUTES.
MANNITOL
• ADMINISTRATION ADVICE
• MANNITOL CRYSTALLISES AT LOW TEMPERATURES (ESPECIALLY 20% SOLUTION);
REDISSOLVE BY WARMING IN HOT WATER AND SHAKING VIGOROUSLY; ALLOW
TO COOL TO BODY TEMPERATURE BEFORE GIVING VIA INFUSION SET WITH
FILTER.

• PRACTICE POINTS
• MANNITOL PRODUCES A MARKED OSMOTIC DIURESIS; URINARY
CATHETERISATION IS REQUIRED FOR ANAESTHETISED OR UNCONSCIOUS
PATIENTS

• THE HYPEROSMOTIC AGENT MOST OFTEN USED IN THE TREATMENT OF ACUTE

OCULAR HYPERTENSION IS IV MANNITOL (ORAL GLYCEROL IS USED
INFREQUENTLY)