甘露醇
別名: Osmitrol, Resectisol, Am-Vet Mannitol, Isotol, Manniject, Osmofundin, Mannitol IV
藥物類別: Osmotic Diuretic
甘露醇是一種急救藥物，必須由專業獸醫人員在具備完善監測設備的醫院環境中給藥。 由於它會引起體內液體的快速轉移，獸醫團隊將會密切監測您寵物的水合狀態、電解質和排尿量，以確保安全並達到最佳療效。
劑量必須由獸醫按你寵物的個別情況決定。切勿在沒有獸醫指導下給予人類藥物或其他寵物的處方藥。
Veterinary professional? See the full dosing-by-species reference on VetSheet →
用途
- Cerebral edema
- Oliguric renal failure
- Cerebral edema
- Oliguric renal failure
- Oliguric renal failure (not anuric)
- Oliguric renal failure (rehydrated, not fluid overloaded)
- Oliguric renal failure (fluid replete)
- Acute glaucoma
- Acute glaucoma (if latanoprost fails)
- Acute primary angle-closure glaucoma
- Increased CSF pressure/cerebral edema
- Increased CSF pressure (critical/deteriorating patient)
- Cerebral edema secondary to trauma
- Cerebral edema
- Oliguric renal failure
- General diuresis/edema
- Increased intracranial pressure from traumatic brain injury (TBI)
- Cerebral edema
- Oliguric renal failure
- Oliguric renal failure (not anuric)
- Oliguric renal failure (rehydrated, not fluid overloaded)
- Oliguric renal failure (fluid replete)
- Acute glaucoma
- Acute glaucoma (if latanoprost fails)
- Acute primary angle-closure glaucoma
- Increased CSF pressure/cerebral edema
- Increased CSF pressure (critical/deteriorating patient)
- Cerebral edema secondary to trauma
給藥方式
IV
可能的副作用
- Fluid and electrolyte imbalances (especially hypernatremia)
- Volume overload (if oliguria persists)
- Nausea and vomiting
- Pulmonary edema
- Congestive heart failure (CHF)
- Tachycardia
- Dizziness and headache (CNS effects)
- Fluid and electrolyte imbalances
- Circulatory overload (at high doses)
- Acidosis (at high doses)
- Thrombophlebitis
- Extravasation injury (oedema and skin necrosis)
- Diarrhoea (if administered orally)
- Acute renal failure (rare)
注意事項與禁忌
- Anuria secondary to renal disease
- Severe dehydration
- Severe pulmonary congestion or pulmonary edema
- Intracranial bleeding (unless during craniotomy - human label)
- Disrupted capillary membrane in the brain (can leak into interstitium and worsen edema)
- Severe pulmonary congestion
- Pulmonary oedema
- Intracranial haemorrhage (relative contraindication; labelled 'use with care' but commonly used in traumatic brain injury)
- **Important Warnings:** * **Halt therapy** if progressive heart failure, pulmonary congestion, or progressive renal failure/damage (increasing oliguria/azotemia) develops. * **Hydration:** Adequate fluid replacement must be administered to dehydrated animals *before* mannitol therapy begins. Use with caution in hypovolemic patients as it can enhance hypotension. * **Crystallization:** Crystals frequently form in solutions >15%. Be certain crystals are dissolved (by warming) before administering. An **in-line IV filter (5 micron)** is highly recommended. * **Blood Products:** Do not give with whole blood products unless at least 20 mEq/L of NaCl is added, otherwise pseudoagglutination may result. * **Glaucoma:** Relatively contraindicated for treating secondary glaucomas, as it may cross the damaged blood-aqueous barrier and increase IOP.
藥物相互作用
- Lithium: Mannitol can increase the renal elimination of lithium
- Sotalol: Mannitol's effects on potassium and magnesium may increase the risk for QT prolongation
- Potassium-depleting diuretics: May exacerbate diuretic-induced hypokalaemia
- Beta-blockers: Concurrent use with potassium-depleting diuretics requires caution
- Ciclosporin: Nephrotoxicity has been described with concurrent use in humans
- Whole blood: Mannitol should never be added to whole blood for transfusion or given through the same IV set
- KCl or NaCl: Do not add to concentrated mannitol solutions (20% or 25%) as a precipitate may form
常見問題
甘露醇用於寵物有甚麼用途？
甘露醇是一種急救藥物，必須由專業獸醫人員在具備完善監測設備的醫院環境中給藥。 由於它會引起體內液體的快速轉移，獸醫團隊將會密切監測您寵物的水合狀態、電解質和排尿量，以確保安全並達到最佳療效。
甘露醇對我的寵物安全嗎？
劑量必須由獸醫按你寵物的個別情況決定。切勿在沒有獸醫指導下給予人類藥物或其他寵物的處方藥。
本文僅供一般健康教育，不能取代專業獸醫意見。如寵物身體不適，請諮詢獸醫。