underlying cause of his condition is severe, or if it is not treated with more definitive
c. Untoward Effects. There are virtually no harmful effects to a single dose of
this drug, nor even to the use of it for a few days. However, on prolonged use for the
treatment of chronic conditions, a number of untoward reactions may occur. The
principal ones include fluid and electrolyte disturbances; susceptibility to infections,
including tuberculosis; failure of wounds to heal; formation of peptic ulcers, which may
bleed or perforate; hyperglycemia (abnormally large amount of blood glucose) and
glycosuria (sugar in the urine); a wasting or weakening of muscle tissue; osteoporosis
(softening of the bone), which may result in spontaneous fractures; and psychosis.
Upon the appearance of any adverse reaction, the drug should be discontinued or the
d. Cautions and Contraindications. For immediate lifesaving therapy, there
are no contraindications to the use of the drug. For the long-range treatment of chronic
diseases, the drug should not be used on clients with peptic ulcers, nor on those who
have a history of psychosis. The drug should be kept from freezing; also, it is subject
e. Supply. The equivalent of 100- or 250-mg of hydrocortisone base is
supplied in a sterile mixing bottle. The lower section of the bottle contains the drug and
the upper section contains sterile water.
4-35. MANNITOL INJECTION--AN OSMOTIC DIURETIC
a. Action. Diuretics are drugs, which increase the excretion of urine. An
osmotic diuretic, such as Mannitol (Osmitrol), easily passes into the renal tubules,
however, it is not significantly reabsorbed. It increases the osmotic pressure of the
glomerular filtrate, decreases tubular reabsorption, and thus increases the volume of
b. Indications. Mannitol injection is indicated for:
(1) Promotion of diuresis, in the prevention or treatment of the oliguric
phase of acute renal failure (following hemolytic transfusion reactions) before
irreversible renal failure becomes established.
Reduction of intracranial pressure and treatment of cerebral edema.
(3) Reduction of elevated intraocular pressure when the pressure cannot be
lowered by other means.
Promoting the urinary excretion of toxic substances.
Use as an irrigating solution in transurethral resection.