Mannitol for

When a patient taking mannitol for increased intracranial pressure is being assessed, which of the following finding would be most important for the nurse to report ... 

Figure 6. Time course of tritiated water uptake or release from bean leaf discs previously exposed to 0.5 ppm ozone for 1 hr immediately prior to experiment. Upper Discs were preincubated in 0.2 M mannitol for 2 hr then transferred to tritiated water. Lower Discs were preincubated in tritiated water then transferred to 0.2 M mannitol. Data of Evans and Ting (13).

The use of urea (Ureaphil, Ur evert) has declined in recent years owing both to its disagreeable taste and to the increasing use of mannitol for the same purposes. When used to reduce cerebrospinal fluid pressure, urea is generally given by intravenous drip. Because of its potential to expand the extracellular fluid volume, urea is contraindicated in patients with severe impairment of renal, hepatic, or cardiac function or active intracranial bleeding. 

An 87-year-old woman, who took acarbose, glibenclamide, and mannitol (for constipation), developed abdominal distention and loss of appetite. An X-ray showed distention of the small intestine, with pockets of small gas bubbles in the submucosal When her drugs... 

Standard markers should be included in all experiments. Usually marker compounds for different permeability classes are used like metoprolol for high permeability and radioactive mannitol for low permeability. Quality assurance criteria define accepted upper permeability values for mannitol (in the case of mannitol many laboratoratories use 1.0 x E-06 cm/sec). Permeability values higher than upper limit should lead to rejection of the test. 

More recently a group of halogenated sugars have been found to have similar properties to the bifunctional alkylating agents 1. 1,6-Dibromo- 1,6-dideoxy-D-mannitol, for example (DBD, Mitobronitol 10) is now in clinical use, but it is believed to act at least in part by transformation in vivo to the bis epoxide... 

Hyponatremia occurs with an increased amount of other solutes in the ECF, causing an extracellular shift of water or intracellular shift of Na. to maintain osmotic balance between the ECF and ICF compartments. The most common cause of this type of hyponatremia is severe hyperglycemia. As a general rule, the Na" decreases —1.6 mmol/L for every 100 mg/dL increase of glucose above 100 mg/dL. The clinical use of mannitol for osmotic diuresis can have a similar effect. 

Roberts I, Schierhout G, Wakai A. Mannitol for acute traumatic brain injury. Cochrane Database Syst Rev 2003. 

Cruz J, Minoja G, Okuchi K. Major clinical and physiological benefits of early high doses of mannitol for intraparenchymal temporal lobe hemorrhages with abnormal pupillary widening A randomized trial. Neurosurgery 2002 51 628-637. 

Sargramostim is supplied in vials of lyophilized powder (with mannitol) for intravenous infusion. Reconstituted with 1 ml of Sterile Water for Injection, USP... 

If ICP monitoring is performed, rapid and abrapt increases of intracranial pressure can be directly addressed by the infusion of mannitol, for example, or the application of ranitidine. In most patients, however, the management of raised intracranial pressure has to be performed without actual information on its severity. Thus, general rules are followed, such as elevation of the head of the bed to 30 degrees, sedation, minimal stimulation or the administration of mannitol three times a day. Mannitol has been shown to improve survival in a group of patients with acute liver failure (Canalese et al., 1982). If renal failure accomplishes acute liver failure, however, a paradoxical effect can occur with mannitol treatment as serum osmolality increases and volume overload may occur. Therefore plasma osmolality must be checked at least twice a day to assure that it remains <320 mos-mol/1 (Poison and Lee, 2005 Rinella and Sanyal, 2006). 

These methods are useful since they avoid the necessity of preparing L-mannitol for the synthesis of 2,3-isopropylidene-5 -glycerol and l-benzyl-5 -glycerol. 

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