A 70 year old man with severe systolic heart failure presents with progressive dyspnea, bibasilar crackles, and lower extremity edema. He is being considered for an osmotic diuretic to reduce intracranial pressure after a recent head injury. Which of the following is the strongest reason to avoid this medication in this patient?
- A)It produces antiandrogen effects with gynecomastia
- B)It causes severe hyperkalemia by blocking aldosterone receptors
- C)It irreversibly injures the proximal tubule
- D)It causes nephrogenic diabetes insipidus
- E)It can worsen pulmonary edema by transiently expanding extracellular fluid volumeGABARITO
Explicação
Mannitol initially increases plasma osmolality and draws water into the intravascular space, which can worsen pulmonary edema in patients with heart failure. It is also avoided in anuric patients because the drug must be filtered to work. Ver explicação completa e trilha adaptativa →