Why is mannitol contraindicated in chf

High doses of mannitol can also be nephrotoxic increased risk in patients with prior renal insufficiency. Mannitol osmolarity effects. J Neurosurg Anesthesiol: , 21 3 ; A year-old man with a history of heart disease has difficulty breathing and is diagnosed with acute pulmonary edema.

Which drug is contraindicated? Mannitol is contraindicated in Pulmonary edema and Pulmonary congestion. Mannitol is an osmotic diuretic, it increases osmolarity of blood and extracts fluid from intracellular compartments into Extracellular compartment. This leads to ECF expansion, and volume overload until diuresis begins. People with congestive heart failure and pulmonary edema cannot handle this extracellular fluid expansion, and their condition deteriorate if Mannitol is given to such cases.

Sign in Register. Also, mannitol may be used in the treatment of haemochromogenuria. It is contraindicated in congestive heart failure and pulmonary oedema. Clinical specialties cardiovascular medicine dermatology diabetes and endocrinology ear, nose and throat evidence-based medicine gastroenterology general information general practice. Indications Proposed as a treatment for neurologic and neurosensory manifestations caused by ciguatera poisoning See Food Poisoning: Fish and Shellfish.

Possible adjunctive agent in treating severe vitamin A toxicity associated with increased intracranial pressure pseudotumor cerebri.

Sometimes used as an adjunct to fluid therapy for acute oliguria resulting from massive rhabdomyolysis See Rhabdomyolysis. Contraindications Severe dehydration. Adverse effects Mannitol may cause excessive expansion of the intravascular space when administered in high concentrations at a rapid rate. This may result in congestive heart failure and pulmonary edema.

Mannitol causes movement of intracellular water to the extracellular space and can produce both transient hyperosmolality and hyponatremia. Generalized electrolyte disturbances may also be seen. Oliguric or anuric renal failure has occurred in patients receiving mannitol. Use in pregnancy.

FDA Category C indeterminate. Drug or laboratory interactions. Diuresis may result in decreased potassium and magnesium levels, which may increase the risk for QT prolongation in patients taking drugs such as sotalol and droperidol. Dosage and method of administration Ciguatera poisoning.

Reportedly most effective when given within 1—2 days of exposure, but case reports describe alleged benefit up to 8 weeks after exposure. Ciguatera poisoning may be accompanied by dehydration, which must be treated with intravenous fluids before the administration of mannitol. Vitamin A—induced pseudotumor cerebri. Give 0.