new_n_lost
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Congestive Heart Failure has Pulmonary Edema as its component and Mannitol can cause Pulmonary Edema. I guess thats y its contraindicated. Furthermore the Osmotic Diuretics cause the Retention of Fluid in the Plasma i.e they extract water from intracellular compartment. thereby increasing the Blood Volume and the Significant increase in the Blood volume is undesirable in CHF.
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| drhouse
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in congestive heart failure there is interstitial pulmonary edema.
now mannitol is exclusive extracellular substance. it draws water in interstitial compartment and worsen the edema.
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| po
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Pharmacokinetics :
Mannitol is not absorbed orally and is given IV as 20 % solution. Distributed in the extra cellular space and extracts water form the intracellular compartment. It is rapidly excreted by the kidney and action starts 30 –60 minutes after administration. Duration of action is 1.5 – 3 hours.
Contraindications
· Pulmonary edema, acute left ventricular failure.
· Cerebral malaria.’
· Intra cranial bleeding.
· In patients with diminished cardiac reserve. Expansion of the extra cellular fluid by mannitol can precipitate congestive cardiac failure due to volume overload.
· If urine flow is inadequate, expansion of the extra cellular fluid may lead to acute water intoxication.
Precaution / Practice Points
· Should be carefully observed for signs of fluid and electrolyte imbalance.
· Renal function to be monitored.
· Administration instruction:
- Infuse over 20 –30 minutes; caution avoid extravasations; monitor CVS status while administering.
- Mannitol should not be administered along with whole blood.
Indications
· To reduce raised intracranial pressure and raised interocular pressure.
· Helps to preserve renal function and urinary output in acute renal failure when administered along with measures to maintain hydration.
· Forced diuresis mainly in barbiturate poisoning.
· To reduce cerebral edema before and after neurosurgery.
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| simi
Forum Elite
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thanks a lot for the explanations
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