ORALDENE MOUTH WASH 0.1% Price

Overview

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This medicine contains an important and useful components, as it consists of
Hexetidineis available in the market in concentration

Name

Mannitol 20%

Precaution

Before initiating **Mannitol 20%**, it is essential for patients to consult their healthcare provider to assess the safety of this drug in their specific case. Several precautions must be considered: - **Renal Impairment**: **Mannitol** is contraindicated in patients with **severe renal impairment** (e.g., anuria or acute kidney failure), as it can worsen renal function due to **renal filtration issues**. In patients with **pre-existing kidney disease**, close monitoring of renal function is essential. - **Dehydration and Electrolyte Imbalance**: **Mannitol** can cause **fluid shifts** and **electrolyte imbalances**, particularly **hypernatremia** and **dehydration**. Careful monitoring of serum electrolytes, especially **sodium and potassium**, is necessary during infusion. - **Pulmonary Edema**: Caution should be taken when administering **Mannitol 20%** to patients with **pulmonary edema** or **heart failure**, as it can exacerbate fluid overload and cause **cardiac complications**. - **Intracranial Hemorrhage**: While **Mannitol** is often used for reducing **intracranial pressure**, it must be used with caution in patients with **active bleeding**, as it can expand the blood volume and increase bleeding. - **Use in Pregnancy**: **Mannitol 20%** should be used in pregnant women only if the potential benefit justifies the risk to the fetus. It falls under category **C**, meaning its safety during pregnancy has not been well established. - **Liver Dysfunction**: Caution should be exercised when administering **Mannitol 20%** to patients with **liver dysfunction** since their ability to handle fluids and electrolytes may be impaired. - **Infusion Rate**: **Mannitol** should be infused at the recommended rate to avoid **rapid changes in fluid balance**, which can lead to severe adverse effects, including **hypotension** and **hyperkalemia**.

Indication

**Mannitol 20%** infusion is primarily used in the following medical conditions: - **Intracranial Hypertension**: **Mannitol 20%** is commonly used to reduce **intracranial pressure (ICP)** in conditions such as **traumatic brain injury**, **brain tumors**, **cerebral edema**, and **intracranial hemorrhage**. It works by drawing fluid out of the brain tissue into the bloodstream, thereby reducing swelling and pressure. - **Acute Glaucoma**: It is used to lower **intraocular pressure (IOP)** in cases of **acute angle-closure glaucoma**. **Mannitol 20%** reduces the pressure in the eyes by drawing fluid from the eye into the bloodstream. - **Renal Protection**: It can be used as an adjunct to **prevent renal failure** in conditions where renal perfusion may be compromised, such as in patients undergoing **cardiac surgery** or **trauma**. - **Promoting Diuresis**: **Mannitol** can help promote urine formation in **acute kidney injury** (AKI) and **oliguric conditions** where the kidneys are not producing sufficient urine. - **Drug Overdose**: **Mannitol 20%** is sometimes used to enhance the elimination of certain toxins or **poisons** by **osmotic diuresis**.

Contra indication

**Mannitol 20%** should not be administered in the following conditions: - **Anuria**: **Mannitol** is contraindicated in patients with **anuria** (lack of urine production), as its diuretic effect requires functioning kidneys to filter and excrete fluids. - **Severe Renal Failure**: Patients with severe renal impairment, particularly those with **acute renal failure** or **chronic kidney disease**, should not receive **Mannitol 20%**, as it could worsen renal function. - **Active Cerebral Hemorrhage**: In patients with **active intracranial hemorrhage**, the use of **Mannitol** may worsen bleeding or lead to worsened intracranial pressure. - **Severe Pulmonary Edema**: It should be avoided in patients with severe pulmonary edema, as it can exacerbate fluid overload and **respiratory distress**. - **Severe Dehydration**: In cases of **severe dehydration**, **Mannitol 20%** should not be used due to its diuretic effects, which can further deplete the body of water and electrolytes.

Side Effect

Common and serious side effects associated with **Mannitol 20%** include: - **Electrolyte Imbalances**: Patients may experience **hyponatremia** (low sodium) or **hypernatremia** (high sodium) due to the diuretic effect of **Mannitol**. **Hypokalemia** (low potassium) may also occur, leading to muscle weakness and arrhythmias. - **Dehydration**: The osmotic diuretic action of **Mannitol** can lead to **dehydration**, causing symptoms such as **thirst**, **dry mouth**, and **decreased urine output**. This can be especially dangerous in patients who are already dehydrated. - **Hypotension**: **Mannitol** can cause **low blood pressure** (hypotension), particularly when administered rapidly or in high doses. This can lead to dizziness, lightheadedness, and fainting. - **Headache**: **Mannitol** infusion may lead to **headache** due to changes in fluid balance and **intracranial pressure**. - **Nausea and Vomiting**: Patients receiving **Mannitol 20%** may experience **nausea** and **vomiting**, particularly when the infusion is given too rapidly. - **Pulmonary Edema**: In rare cases, **Mannitol** can exacerbate **pulmonary edema**, especially in patients with underlying cardiac or lung conditions, leading to shortness of breath, coughing, and fluid retention in the lungs. - **Renal Failure**: Overuse or improper dosing of **Mannitol 20%** can lead to **acute renal failure**, especially in patients with pre-existing kidney conditions. - **Extravasation**: If **Mannitol 20%** is inadvertently infused outside the vein, it can cause significant tissue damage or **extravasation** injury. Serious side effects such as **respiratory failure**, **severe dehydration**, and **cardiac arrhythmias** require immediate medical attention.

Pregnancy Category ID

3

Mode of Action

**Mannitol 20%** acts primarily as an **osmotic diuretic**, exerting its effects by creating an osmotic gradient that draws water from tissues into the bloodstream, increasing urine production. Here's how it works: - **Increased Plasma Volume**: **Mannitol** increases the plasma volume, which can help reduce **intracranial pressure (ICP)** in conditions like **brain injury** or **intracranial hemorrhage**. It draws fluid from the brain parenchyma into the bloodstream. - **Decreases Intraocular Pressure**: **Mannitol** draws water out of the ocular tissues, thus reducing **intraocular pressure (IOP)** in **glaucoma**. - **Kidney Filtration**: In the kidneys, **Mannitol** increases the **glomerular filtration rate** (GFR), which helps prevent or manage **acute renal failure** by promoting diuresis. - **Electrolyte Shifts**: Due to its osmotic properties, **Mannitol** can alter the distribution of **electrolytes** (e.g., sodium and potassium), leading to fluid and electrolyte imbalances.

Interaction

**Mannitol 20%** may interact with several other drugs, leading to alterations in its effects or increased risk of adverse reactions: - **Cardiovascular Medications**: **Mannitol** can enhance the effects of **antihypertensive agents**, leading to **hypotension**. Patients on medications like **ACE inhibitors**, **beta-blockers**, or **calcium channel blockers** may experience a significant drop in blood pressure. - **Diuretics**: When used in combination with **loop diuretics** (e.g., **furosemide**) or **thiazide diuretics**, **Mannitol** may cause excessive diuresis and **electrolyte imbalances**. Close monitoring of electrolytes and renal function is necessary. - **Lithium**: **Mannitol** can increase **lithium levels** by reducing renal clearance, leading to an increased risk of **lithium toxicity**. Monitoring lithium levels is advised when these drugs are used together. - **Aminoglycoside Antibiotics**: When used concurrently with **aminoglycoside antibiotics** (e.g., **gentamicin**), **Mannitol** may increase the risk of **nephrotoxicity**. - **Anticoagulants**: **Mannitol** may alter the **volume of distribution** of **anticoagulants** such as **warfarin**, affecting the drug’s effectiveness and increasing bleeding risk. - **Corticosteroids**: Concurrent use with **corticosteroids** may increase the risk of **fluid retention** and **electrolyte imbalances**, including **hypokalemia**. Patients should always inform their healthcare provider of all the medications they are taking to reduce the risk of dangerous interactions.

Pregnancy Category Note

Information not available

Adult Dose

The recommended dose of **Mannitol 20%** varies depending on the clinical indication: - **For Intracranial Pressure Reduction**: The initial dose is usually **0.25 to 1 g/kg** body weight, administered as a **bolus** or over a period of **20-60 minutes**. The dose may be repeated if necessary. - **For Acute Glaucoma**: **1.5-2 g/kg** body weight is typically infused over **30-60 minutes**. - **For Acute Renal Failure or Oliguria**: **Mannitol 20%** may be administered as **0.25-1 g/kg** body weight as an initial dose, followed by continuous infusion if needed. - **For Drug Overdose or Toxin Elimination**: The dosing for **Mannitol** in drug elimination is typically **1-2 g/kg** body weight, depending on the specific circumstances.

Child Dose

In pediatric patients, the dosing for **Mannitol 20%** typically follows a weight-based approach: - **For Intracranial Pressure or Cerebral Edema**: The dose is generally **0.25-1 g/kg** body weight, infused over **20-60 minutes**. - **For Acute Glaucoma**: Pediatric doses are typically around **1-2 g/kg** body weight, depending on the child's age and weight. Careful monitoring of **fluid balance**, **electrolytes**, and **renal function** is required in pediatric patients, as their ability to handle osmotic agents may vary.

Renal Dose

**Mannitol** should be avoided or used with caution in patients with **renal impairment** (e.g., **severe renal failure** or **anuria**). In cases of mild-to-moderate renal impairment, dosing adjustments may be required, but **close monitoring of renal function**, **electrolytes**, and **fluid balance** is critical.

Administration

Information not available