Dose:    1.0 gram/kg/dose for hydrocephalus
               0.2 ml/kg/dose PR as an enema

Frequency:    Q 3 to 6 hours for hydrocephalus

Comments: Glycerin is an osmotic diuretic that decreases cerebral spinal fluid (CSF) production.  In treating posthemorrhagic hydrocephalus, the starting dose of glycerin can be given as 0.5 gm/kg every 3 hours or 1.0 gram every 6 hours. Serum osmolality, sodium, BUN, and serum glucose must be closely monitored.
    Glycerin is also used as a hyperosmolar agent for enemas. After administration, it usually produces a bowel movement within minutes.  The administration of an enema appears to be more effective than the use of a suppository.  An enema should not typically be administered more frequently than once per day. Further comments on Glycerin.

Toxicity: Nausea, vomiting, and headaches have occurred with use in adults. Severe dehydration, cardiac arrhythmias, and hyperosmolar nonketotic coma may rarely result from treatment (Facts and Comparisons, Inc. Drug Facts and Comparisons. Olin, B.R. ed. St. Louis, MO:Facts and Comparisons, Inc; 1996, page 139j). Cantose (J. Neurosurg. 21:278, 1965) reported there were no significant effects noted in adults, however, the incidence of problems in the newborn were significant. Twenty-five percent developed hypernatremia or diarrhea and vomiting. If used for an enema, glycerol may  produce irritation or burning of the rectal mucosa.  It can also cause rectal bleeding.

Preparation: Glycerin (glycerol) is available in a 60 ml bottle with a concentration of 0.5 grams/ml..  Store at room temperature.  It is also available as a suppository.  Cut a small sliver for administration. To administer an enema, use a 1 ml syringe with surgilube for dosing.