Osmotic Diuretics

Osmotic diuretics increase the concentration (osmolality) of the plasma and fluid in the renal tubules. Sodium, chloride, potassium (to a lesser degree), and water are excreted. Osmotic diuretics are used to prevent kidney failure, decrease intracranial pressure (ICP) (cerebral edema), and decrease intraocular pressure (IOP) as is the case with glaucoma.

Mannitol is a potent potassium-wasting osmotic diuretic used in emergencies to treat intraocular pressure. Mannitol is also used with cisplatin and carboplatin in cancer chemotherapy to induce a frank diuresis for decreased side effects of treatment.

Mannitol is the most frequently prescribed osmotic diuretic. The side effects and adverse reactions include fluid and electrolyte imbalance, pulmonary edema from rapid shift of fluids, nausea, vomiting, tachycardia from rapid fluid loss, and acidosis.

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