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The specifications of Mannitol Injection
【chemical composition】:D-mannitol
【Molecular formula】：C6H14O6
【molecular weight】：182.17四川名小吃
【Auxiliary materials】：Hydrochloric acid and sodium hydroxide
【Character】:The quality of this product is colorless clear liquid.
【Indications】: 1.tissue dehydrating medicine. It is ud to treat brain edema caud by various reasons, reduce intracranial pressure and prevent cerebral hernia.
3.osmotic diuretic. It is ud to identify oliguria caud by pre renal factors or acute renal failure. It can
also be applied to prevent acute tubular necrosis caud by various caus.
4.as a supplementary diuretic measure to treat nephrotic syndrome and ascites due to cirrhosis, especially when hypoproteinemia occurs.
5.for some drug overdo or poison poisoning (such as barbiturate, lithium, salicylate and bromide), this drug can promote the excretion of the above substances and prevent renal toxicity.
/doc/cf9eebb23086bceb19e8b8f67c1cfad6195fe991.html ed as a washing agent for transurethral rection of prostate.
7.preoperative bowel preparation.阿胶成分
【specification】：250ml:50g
【Usage and dosage】: 1. adult: (1).Diuresis. The usual dosage is 1 to 2g/kg by weight, and 20% drops of 250ml are injected intravenously, and the dosage is adjusted to maintain 30 to 50ml urine per hour. (2)Treatment of cerebral edema, intracranial hypertension and glaucoma. According to body weight 0.25 to 2g/kg, the concentration was 15% to 25% in 30~60 minutes. When the patient is weak, the do should be reduced to 0.5g/kg. The renal function was followed up cloly. (3) Identifi
cation of pre renal oliguria and renal oliguria. According to the weight 0.2g/kg, 20% concentration in 3~5 minutes intravenous drip, such as after 2~3 hours after the medication, the urine volume is still less than 30~ 50ml, the maximum trial, if still no reaction should stop the drug. Patients with heart failure or heart failure are advid to u caution or not. (4) Prevention of acute renal tubular necrosis. First give 12.5 to 25g, 10 minutes intravenous drip, if no special situation, then
50g, 1 hours intravenous drip, if the urine can be maintained at more than 50ml per hour, then can continue to u 5% solution static drops; if ineffective, stop the drug immediately. (5)Treatment of drugs, poison poisoning.50g adjusted the do by 20% drops of intravenous drip to maintain urine volume at 100 to 500ml per hour.
2.children.Diuresis. (1) According to body weight 0.25 to 2g/kg or by body surface area 60g/m2, intravenous infusion of 15% to 20% solution within 2~6 hours.
(2)Treatment of cerebral edema, intracranial hypertension and glaucoma. According to body weight 1 to 2g/kg or by body surface area 30 to 60g/m2, intravenous infusion of 15% to 20% concentration solution in 30~60 minutes. When the patient is weak, the do is reduced to 0.5g/kg.
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(3)Identification of pre renal oliguria and renal oliguria. According to the body weight 0.2g/kg or the b
ody surface area 6g/m2, 15% ~ 25% concentration of intravenous drip for
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3~5 minutes, if the urine volume of 2~3 hours after medication no significant increa, can be reud 1 times, if still no reaction is no longer ud.
(4)Treatment of drugs, poison poisoning. According to body weight 2g/kg or 60g/m2 according to body surface area, 5% to 10% solution was dripped intravenously. 【Adver reactions】: 1. water and electrolyte disorders are most common. (1) a rapid and large amount of mannitol can cau the accumulation of mannitol in the body, and a rapid increa in blood volume (especially in acute and chronic renal failure), which leads to heart failure (especially when cardiac
dysfunction),dilute hyponatremia,and even hyperkalemia. (2) inappropriate excessive diuresis leads to decread blood volume and aggravated oliguria. (3) a large number of intracellular fluid transfer to extracellular tissue can cau tissue dehydration and can cau symptoms of central nervous system.
2. chills, fever.
3. dysuria is difficult.
4. thrombotic phlebitis.
写信给监狱的亲人怎么写5. mannitol exudation can cau tissue edema and skin necrosis.
6. allergies cau rash, urticaria, dyspnea, and anaphylactic shock.
7. dizziness and blurred vision.
8. hyperosmotic caus thirst.
9. osmotic nephropathy (or mannitol nephropathy) is mainly en in high do rapid intravenous infusion. The mechanism has not yet been fully elucidated. It may be caud by excessive elevation of osmotic pressure in renal tubular fluid induced by mannitol, which may lead to injury of renal tubular epithelial cells. Pathological findings showed that the renal tubular epithelial cells were swollen and vacuolated. Clinically, there is a decrea in urine volume and even acute renal failure. Osmotic nephropathy is commonly en in elderly patients with reduced renal blood flow and hyponatremia and dehydration.【Taboos】: 1. the patients who have been diagnod with acute renal tubular necrosis, including tho who have no respon to mannitol, increa the volume of blood and increa the burden of the heart becau of the accumulation of mannitol.
2. the rious water lost.
3. patients with intracranial active bleeding aggravate bleeding due to dilatation, except for intracranial surgery.多肉盆栽
4. acute pulmonary edema, or vere pulmonary ecchymosis.
【Cautions】: 1.except for intestinal preparation, intravenous administration should be given.
2.mannitol is easy to crystallize when it is cold, so it should be carefully checked before application. If there is crystallization, it can be placed in hot water or oscillate vigorously until it is completely dissolved before it is ud. When the concentration of mannitol is above 15%, the infusion t with filter should be ud.
3.choo the appropriate concentration according to the condition and avoid unnecessary u of high concentration and large do.
4.the u of low concentration and mannitol containing Sodium Chloride Solution can reduce the chance of over dehydration and electrolyte disturbance.
5. when treating salicylate or barbiturates poisoning, sodium bicarbonate should be ud to alkylate urine.
6. caution should be applied to the following situations: (1) patients with obvious heart and lung dysfunction may cau congestive heart failure due to the sudden increa of blood volume caud by this medicine. (2) hyperkalemia or hyponatremia. (3) low blood volume. After application, it can aggravate the condition due to the urine and make the original low blood volume temporarily dilated. (4) reduced excretion of vere renal failure caus the drug to accumulate in the body, resulting in a marked increa in blood volume, aggravating cardiac load, inducing or aggravating heart failure. (.) an intolerant of mannitol.
7.high do mannitol does not appear diuretic reaction, which can significantly increa plasma osmotic concentration. Therefore, we should be vigilant against hypertonic infiltration.
8.follow up examination: (1) blood pressure. (2) renal function. (3) the concentration of blood electrolyte, especially Na+ and K+. (4) urine volume.
【Pregnant women and lactating women u】1. mannitol through the placental barrier.
2. it is not clear whether it can be creted by milk.
【children u】The u of drugs for children is not clear and is not recommended. 【The elderly u】The elderly are more likely to suffer kidney damage by using the drug, and the chance of kidney damage increas with age. Control the amount properly. 【Drug interaction】1.increas the toxic effect of digitalis and is associated with hypokalemia.
2.increa the diuretic and intraocular pressure effects of diuretics and carbonic anhydra inhibitors. When combined with the drugs, dosage should be adjusted. 【The pharmacology and toxicological】literature reports that mannitol is monosaccharide and is not metabolized in the body. After glomerular filtration, the mannitol is rarely reabsorbed in the renal tubules and plays the role of permeation diuresis.
1. the dehydration of the tissues. Increa the osmotic pressure of plasma and lead to the intravascular water in the tissue, including the eye, brain and cerebrospinal fluid, so as to reduce the edema of the tissue and reduce the pressure of intraocular pressure, intracranial pressure and cerebrospinal fluid capacity and pressure. 1g mannitol can produce osmotic concentration of 5.5mOsm, injection of 100g mannitol can make 2000ml cells in water transfer to extracellular, urinary sodium excretion 50g.
2. diuretic effect. The diuretic mechanism of mannitol is divided into two aspects: (1) mannitol increas blood volume and promotes the cretion of prostaglandin I2, thus expanding the renal vesls and increasing renal blood flow, including renal medullary blood flow. Glomerular arterioles dilated, glomerular capillary pressure incread, and cortical glomerular filtration rate incread. (2) it is rare since the glomerulonephritis 【Pharmacokinetics】studies reported that mannitol rapidly entered the extracellular fluid after intravenous injection without entering the cell. However, when blood mannitol concentration is high or acidosis occurs, mannitol can pass through blood brain barrier and cau intracranial pressure rebound. Diuresis occurred 1 hours after intravenous injection and lasted for 3 hours. The decrea of intraocular pressure and intracranial pressure occurred within 15 minutes after intravenous injection. The peak time was 30-60 minutes, and maintained for 3-8 hours. This drug can be produced from the liver glycogen,
but becau of rapid renal excretion after intravenous injection, it is generally rare to metabolize the liver through the liver. The half-life (t1/2) of the drug is 100 minutes and can be extended to 6 hours when acute renal failure occurs. When renal function was normal, mannitol 100g was injected intravenously, and 80% of them were excreted by kidney in 3 hours.【Storage】Storage and shading, clod and prerved.
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周易摇卦
【The period of validity】24 months
【executive standard】《Chine pharmacopoeia》2015（II）
【approval number】H37021265
