Drugs that may compromise renal or cardiovascular status should be used with caution in combination with osmotic drugs. Systemic absorption of topically administered beta blocker, for example, may further compromise patients at risk for congestive heart failure, predisposing them to untoward effects due to osmotic drugs. Osmotic diuretic drugs given to patients receiving angiotensin-converting enzyme inhibitors or other drugs for the treatment of high blood pressure may produce systemic hypotension.
A white flocculent precipitate may form from contact of mannitol with polyvinyl chloride surfaces. Mannitol, therefore, should not be placed in a polyvinyl chloride bag prior to intravenous administration.
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