By increasing the osmotic pressure of plasma and subsequent reabsorption without filtering results in retention of water in the tubules and increases urine volume. Boosting plasma osmolarity, causing movement of fluid from the tissue (in particular, the eyeball, the brain) in the bloodstream. No effect on glomerular filtration. Urine output is accompanied by a moderate increase in natriuresis without substantially affecting the K + excretion. The andriol diuretic effect is higher, the higher the concentration (dose). Not effective for abuse filtration renal function, as well as azotemia in patients with liver cirrhosis and ascites. It causes an increase in blood volume.

Indications for use
of brain edema; cranial hypertension (in patients with renal or hepatic renal failure); acute attack of glaucoma; status epilepticus; oliguria acute renal hepatic or renal failure with preserved kidney filtration capacity (in combination therapy); post-transfusion complications after administration of incompatible blood; forced diuresis in poisoning by barbiturates and salicylates; for prevention of hemolysis during operations with extracorporeal circulation for the prevention of renal ischemia and associated acute renal failure.

Hypersensitivity to the drug, anuria with acute tubular necrosis with severe kidney disease, hemorrhagic stroke, severe dehydration, subarachnoid hemorrhage (other than bleeding when performing craniotomy), pulmonary edema with acute left ventricular failure, congestive heart failure, hypokalemia, chloropenia , hyponatremia. Used with caution during pregnancy and lactation.

Dosing and Administration
Intravenous (slow jet or drip). Prophylactic dose is 0.5 g / kg body weight, therapeutic – 1-1.5 g / kg. The daily dose should not exceed 140-180 g In operations with extracorporeal circulation unit preparation is administered in a dose of 20-40 g immediately prior to perfusion. Patients with oliguria should first enter intravenously a test dose (200 mg / kg) for 3-5 minutes. If after 2-3 hours will not be marked diuresis increasing speed up to 30-50 ml / h, the further administration of the drug should be avoided.

Side effects
of violations of water-electrolyte metabolism (increased blood volume, hyponatremia, rarely – hyperkalemia), dehydration (indigestion, muscle weakness, dry skin, dry mouth, thirst, seizures, hallucinations, decreased blood pressure). Rarely -tahikardiya, chest pain, thrombophlebitis, skin rash.

Interaction with other drugs
is possible to increase the toxic effect andriol of cardiac glycosides (associated with hypokalemia).

When left ventricular failure should be combined Mannitol with quick “loop” diuretics (because of the risk of pulmonary edema).
Need to monitor blood pressure, urine output, blood concentrations of serum electrolytes (potassium, sodium).
In the case of the introduction of the drug symptoms such as headache, vomiting, dizziness, visual disturbances should discontinue administration and eliminate the development of complications such as subdural and subarachnoid hemorrhage. When you see signs of dehydration is necessary to introduce into the body fluid. Can be used in heart failure (only in combination with the “loop” diuretics) and hypertensive crisis with encephalopathy.
Reintroducing Mannitol should be under the control of indicators of water and electrolyte balance of blood.
In the case of loss of the drug crystals andriol are heated in a water bath at a temperature of 50 to 70 ° C with shaking until complete dissolution of the crystals. When cooling to a temperature (36-38 °), the crystals will not fall again, the drug is fit for use. how much to inject for weight loss

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