MECHANISM OF ACTION-
It appears to limit tubular water and electrolyte reabsorption in a variety of ways:
1. It retains water isoosmatically in PT – dilute the luminal fluid which opposes NaCl reabsorption.
2. It inhibits the transport process in AscLH which appears to be the largest contributor to the diuresis.
1. Increased intraocular tension
2. To maintain g.f.r and urine flow in impending acute renal failure
3. To counteract low osmality of plasma/e.c.f due to rapid haemodialysis
1. Pulmonary congestion
2. Fluid and electrolyte imbalance
4. Electrolyte loss
Mannitol elevates blood plasma osmality , resulting in enhanced flow of water from tissues, including the brain and cerebrospinal fluid, into interstitial fluid and plasma. As a result, cerebral edema , elevated intracranial pressure, and cerebrospinal fluid volume and pressure may be reduced.
Mannitol + Neomycin = damage to the kidneys or hearing loss
Mannitol + Streptomycin = damage to the kidneys or hearing loss
Mannitol + Diazoxide = Diazoxide may increase the hypotensive activity of Mannitol.
Reference- Tripathi KD "Essential of medical pharmacology" 7th edition, page no- 156,579,590,591