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Encyclopedia > Mannitol
Mannitol
Systematic (IUPAC) name
(2R,3R,4R,5R)-Hexane-1,2,3,4,5,6-hexol
Identifiers
CAS number 69-65-8
ATC code A06AD16 B05BC01 B05CX04
PubChem 453
DrugBank APRD01083
Chemical data
Formula C6H14O6 
Mol. mass 182.172
Pharmacokinetic data
Bioavailability ~7%
Metabolism Hepatic, negligible.
Half life 100 minutes
Excretion Renal: 90%
Therapeutic considerations
Pregnancy cat.

C: (USA) Image File history File links No higher resolution available. ... IUPAC nomenclature is a system of naming chemical compounds and of describing the science of chemistry in general. ... CAS registry numbers are unique numerical identifiers for chemical compounds, polymers, biological sequences, mixtures and alloys. ... The Anatomical Therapeutic Chemical Classification System is used for the classification of drugs. ... A division of the Anatomical Therapeutic Chemical Classification System A Alimentary tract and metabolism // A06A Laxatives A06AA Softeners, emollients A06AA01 Liquid paraffin A06AA02 Docusate sodium A06AA51 Liquid paraffin, combinations A06AB Contact laxatives A06AB01 Oxyphenisatine A06AB02 Bisacodyl A06AB03 Dantron A06AB04 Phenolphthalein A06AB05 Castor oil A06AB06 Senna glycosides A06AB07 Cascara A06AB08 Sodium... A section of the Anatomical Therapeutic Chemical Classification System. ... A section of the Anatomical Therapeutic Chemical Classification System. ... PubChem is a database of chemical molecules. ... The DrugBank database available at the University of Alberta is a unique bioinformatics and cheminformatics resource that combines detailed drug (i. ... A chemical formula is a concise way of expressing information about the atoms that constitute a particular chemical compound. ... For other uses, see Carbon (disambiguation). ... General Name, Symbol, Number hydrogen, H, 1 Chemical series nonmetals Group, Period, Block 1, 1, s Appearance colorless Atomic mass 1. ... General Name, symbol, number oxygen, O, 8 Chemical series nonmetals, chalcogens Group, period, block 16, 2, p Appearance colorless (gas) very pale blue (liquid) Standard atomic weight 15. ... The molecular mass (abbreviated Mr) of a substance, formerly also called molecular weight and abbreviated as MW, is the mass of one molecule of that substance, relative to the unified atomic mass unit u (equal to 1/12 the mass of one atom of carbon-12). ... In pharmacology, bioavailability is used to describe the fraction of an administered dose of unchanged drug that reaches the systemic circulation, one of the principal pharmacokinetic properties of drugs. ... Drug metabolism is the metabolism of drugs, their biochemical modification or degradation, usually through specialized enzymatic systems. ... The liver is an organ present in vertebrates and some other animals. ... It has been suggested that Effective half-life be merged into this article or section. ... The kidneys are important excretory organs in vertebrates. ... The kidneys are organs that filter wastes (such as urea) from the blood and excrete them, along with water, as urine. ... The pregnancy category of a pharmaceutical agent is an assessment of the risk of fetal injury due to the pharmaceutical, if it is used as directed by the mother during pregnancy. ...

Legal status

? The regulation of therapeutic goods, that is drugs and therapeutic devices, varies by jurisdiction. ...

Routes Intravenous
Oral

Mannitol or hexan-1,2,3,4,5,6-hexol (C6H8(OH)6) is an osmotic diuretic agent and a weak renal vasodilator. It is a sorbitol stereoisomer. In pharmacology and toxicology, a route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body 1. ... An intravenous drip in a hospital Intravenous therapy or IV therapy is the administration of liquid substances directly into a vein. ... male human mouth The mouth, also known as the buccal cavity or the oral cavity, is the orifice through which an organism takes in food and water. ... Osmosis is the net movement of water across a partially permeable membrane from a region of high solvent potential to an area of low solvent potential, up a solute concentration gradient. ... A diuretic (colloquially called a water pill) is any drug or herb that elevates the rate of bodily urine excretion (diuresis). ... The kidneys are organs that filter wastes (such as urea) from the blood and excrete them, along with water, as urine. ... Vasodilation is where blood vessels in the body become wider following the relaxation of the smooth muscle in the vessel wall. ... Sorbitol, also known as glucitol, is a sugar alcohol the body metabolises slowly. ... Stereoisomerism is the arrangement of atoms in molecules whose connectivity remains the same but their arrangement in space is different in each isomer. ...


It was originally isolated from manna, and may also be referred to as Mannite and Manna Sugar.[1] Not to be confused with the rune Mannaz. ...

Contents

Chemical properties

Chemically, mannitol is a sugar alcohol, or a polyol; it is similar to xylitol or sorbitol. However, mannitol has a tendency to lose a hydrogen ion in aqueous solutions, which causes the solution to become acidic. For this, it is not uncommon to add a substance to adjust its pH, such as sodium bicarbonate. A sugar alcohol (also known as a polyol, polyhydric alcohol, or polyalcohol) is a hydrogenated form of carbohydrate, whose carbonyl group (aldehyde or ketone, reducing sugar) has been reduced to a primary or secondary hydroxyl group. ... The name polyols refers to chemical compounds containing multiple hydroxyl groups. ... Xylitol, also called wood sugar or birch sugar, is a five-carbon sugar alcohol that is used as a sugar substitute. ... Sorbitol, also known as glucitol, is a sugar alcohol the body metabolises slowly. ... General Name, Symbol, Number hydrogen, H, 1 Chemical series nonmetals Group, Period, Block 1, 1, s Appearance colorless Atomic mass 1. ... This article is about the electrically charged particle. ... For other uses, see Acid (disambiguation). ... For other uses, see PH (disambiguation). ... Flash point Non-flammable. ...


Uses

Mannitol is used clinically to reduce acutely raised intracranial pressure, until more definitive treatment can be given, e.g. after head trauma (although significant controversy exists over this use), and to treat patients with oliguric renal failure. It is administered intravenously, and is filtered by the glomerulus of the kidney, but is incapable of being reabsorbed from the renal tubule, resulting in decreased water and Na+ reabsorption via its osmotic effect. Consequently, mannitol increases water and Na+ excretion, thereby decreasing extracellular fluid volume. Intracranial pressure, (ICP), is the pressure exerted by the cranium on the brain tissue, cerebrospinal fluid (CSF), and the brains circulating blood volume. ... Head injury is a trauma to the head, that may or may not include injury to the brain (see also brain injury). ... An intravenous drip in a hospital Intravenous therapy or IV therapy is the administration of liquid substances directly into a vein. ... Glomerulus refers to two unrelated structures in the body, both named for their globular form. ... The kidneys are organs that filter wastes (such as urea) from the blood and excrete them, along with water, as urine. ... Nephron of the kidney A nephron is the basic structural and functional unit of the kidney. ... For sodium in the diet, see Edible salt. ... Osmosis is the net movement of water across a partially permeable membrane from a region of high solvent potential to an area of low solvent potential, up a solute concentration gradient. ...


Mannitol can also be used to open the blood-brain barrier by temporarily shrinking the tightly coupled endothelial cells that make up the barrier. This makes mannitol indispensable for delivering various drugs directly to the brain (e.g. in the treatment of Alzheimer's disease). The blood-brain barrier (BBB) is a membranic structure that acts primarily to protect the brain from chemicals in the blood, while still allowing essential metabolic function. ... The endothelium is the layer of thin, flat cells that lines the interior surface of blood vessels, forming an interface between circulating blood in the lumen and the rest of the vessel wall. ... For other uses, see Brain (disambiguation). ...


Mannitol is also used as a sweetener for people with diabetes. Since mannitol has a negative heat of solution, it is used as a sweetener in "breath-freshening" candies, the cooling effect adding to the fresh feel. In doses larger than 20g, mannitol acts as a laxative, and is sometimes sold as a laxative for children. It has been suggested that this article or section be merged with Sugar substitute. ... This article is about the disease that features high blood sugar. ... Heat of solution is the quantity of heat evolved or absorbed when one mole of a solute is dissolved in a large volume of a solvent. ... Laxatives are foods, compounds, or drugs taken to induce bowel movements, most often taken to treat constipation. ...


It is sometimes used as an adulterant or cutting agent for heroin, methamphetamines or other illicit drugs. In popular culture, when it is used in this manner, it is often referred to as baby laxative. Many television shows and films depicting drug culture make such references to baby laxative when in fact they are referring to Mannitol.[citation needed] Adulterants are chemical substances which should not be contained within other substances (eg. ... A cutting agent is a chemical used to cut (adulterate) illicit drugs with something less expensive than the drug itself. ... For other uses, see Heroin (disambiguation). ... This article is about the psychostimulant, d-methamphetamine. ...


Mannitol can also be used to temporarily encapsulate a sharp object (such as a helix on a lead for an artificial pacemaker) while it is passing through the venous system. Because it dissolves readily in blood, the sharp point will become exposed by the time it reaches its destination. A pacemaker, scale in centimeters A pacemaker (or artificial pacemaker, so as not to be confused with the hearts natural pacemaker) is a medical device which uses electrical impulses, delivered by electrodes contacting the heart muscles, to regulate the beating of the heart. ...


Mannitol may be administered in cases of severe Ciguatera poisoning. Severe ciguatoxin, or "tropical fish poisoning" can produce stroke-like symptoms. Chemical structure of the ciguatoxin CTX1B Ciguatera is a foodborne illness poisoning in humans caused by eating marine species whose flesh is contaminated with a toxin known as ciguatoxin, which is present in many micro-organisms (particularly, the micro-algae Gambierdiscus toxicus) living in tropical waters. ... Ciguatera is a foodborne illness poisoning in humans caused by eating marine species whose flesh is contaminated with a toxin known as ciguatoxin, which is present in many micro-organisms (particularly, the micro-algae Gambierdiscus toxicus) living in tropical waters. ...


Mannitol is a non-permeating molecule i.e. it cannot cross biological membranes.


Mannitol is commonly used in the circuit prime of a heart lung machine during cardiopulmonary bypass (CPB). The presence of mannitol preserves renal function during the times of low blood flow and pressure, while the patient is on bypass. The solution prevents the swelling of endothelial cells in the kidney, which may have otherwise reduced blood flow to this area and resulted in cell damage. A Heart-Lung Machine (upper right) in a Coronary Artery Bypass surgery (CABG) Cardiopulmonary bypass (CPB) is a technique that temporarily takes over the function of the heart and lungs during surgery. ... A Heart-Lung Machine (upper right) in a Coronary Artery Bypass surgery (CABG) Cardiopulmonary bypass (CPB) is a technique that temporarily takes over the function of the heart and lungs during surgery. ... The endothelium is the layer of thin, flat cells that lines the interior surface of blood vessels, forming an interface between circulating blood in the lumen and the rest of the vessel wall. ...


Mannitol is also being developed by an Australian pharmaceutical company as a treatment for cystic fibrosis and bronchiectasis and as a diagnostic test for airway hyperresponsiveness. The mannitol is orally inhaled as a dry powder through what is known as an osmohaler. The critical component of the mannitol being the particle size distribution (PSD). The company has marketing approval for its diagnostic in Australia and Europe and is currently applying for approval from the FDA.


Chemical Abstract Registry Numbers for Mannitol are: 123897-58-5 69-65-8 75398-80-0 85085-15-0


Controversy

The three studies[2], [3], [4] which initially found that mannitol was effective in cases of severe head injury have been the subject of a recent investigation[5]. Although several authors are listed, the others had no knowledge of how, where, or even if the patients were recruited, meaning that the papers were essentially conducted by Dr. Cruz, who killed himself in 2005. Further, the Federal University of São Paulo, which he gave as his affiliation, has never employed him. Currently, therefore, the Cochrane review recommending mannitol[6] has been withdrawn pending re-evaluation, as there is some evidence that mannitol may worsen cerebral oedema[7]. The Cochrane Collaboration developed in response to Archie Cochranes call for systematic, up-to-date reviews (currently known as systematic reviews) of all relevant randomized clinical trials of health care. ...


References

  1. ^ Cooley's Cyclopaedia of Practical Receipts, 6th ed. (1880)
  2. ^ Cruz J, Minoja G, Okuchi K. Improving clinical outcomes from acute subdural hematomas with the emergency preoperative administration of high doses of mannitol: a randomized trial. Neurosurgery. 2001 Oct;49(4):864-71. PMID 11564247
  3. ^ Cruz J, Minoja G, Okuchi K. Major clinical and physiological benefits of early high doses of mannitol for intraparenchymal temporal lobe hemorrhages with abnormal pupillary widening: a randomized trial. Neurosurgery. 2002 Sep;51(3):628-37; discussion 637-8. PMID 12188940
  4. ^ Cruz J, Minoja G, Okuchi K, Facco E. Successful use of the new high-dose mannitol treatment in patients with Glasgow Coma Scale scores of 3 and bilateral abnormal pupillary widening: a randomized trial. J Neurosurg. 2004 Mar;100(3):376-83. PMID 15035271
  5. ^ Roberts I, Smith R, Evans S. Doubts over head injury studies. BMJ. 2007 Feb 24;334(7590):392-4. PMID 17322250
  6. ^ Wakai A, Roberts I, Schierhout G. Mannitol for acute traumatic brain injury. Cochrane Database Syst Rev. 2005 Oct 19;(4):CD001049. PMID 16235278
  7. ^ Kaufmann AM, Cardoso ER. Aggravation of vasogenic cerebral edema by multiple-dose mannitol. J Neurosurg. 1992 Oct;77(4):584-9. PMID 1527619

External links


  Results from FactBites:
 
Mannitol Treatment (1606 words)
Mannitol, an inert sugar, is a selective, strong diuretic which exclusively reduces the intracellular water retention.
The Mannitol is helpful in counteracting the neuroinflammation in postoperative stage, and specifically in patients who cannot tolerate the inflammatory response against hardware inserted surgically.
As the Mannitol has a tendency to crystallize, the IV should be applied in 1-1 ½ hours.
ROQUETTE : world’s leader of polyols - an extensive range of high-quality starch derivatives for the whole ... (1124 words)
Le mannitol est le constituant essentiel de la manne, exsudat sucré du frêne.
Le mannitol est le moins soluble et le moins hygroscopique des polyols cristallisés.
Le mannitol peut également être associé à un sirop de glucose hydrogéné comme le LYCASIN® pour faire des sucres cuits à durée de vie améliorée, ce qui permet de les conserver dans des emballages conventionnels.
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