Drug Index

Glycopyrrolate

 
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Mechanism :

Glycopyrrolate, like other anticholinergic agents, inhibits the action of acetylcholine on structures innervated by postganglionic cholinergic nerves and on smooth muscles that respond to acetylcholine.


Indication :

• Pre-anaesthetic medication

• Drooling

• Control of Secretions (off-label)

• Neuromuscular Blockade reversal


Contraindications :

Known hypersensitivity to glycopyrrolate or any of its inactive ingredients, contraindicated in patients with the following concurrent conditions: glaucoma; obstructive uropathy; obstructive disease of the gastrointestinal tract; paralytic ileus, intestinal atony of the elderly or debilitated patient; unstable cardiovascular status in acute hemorrhage; severe ulcerative colitis; toxic megacolon complicating ulcerative colitis; myasthenia gravis


Dosing :

Pre-anaesthetic medication:

>1 month: 4-9 mcg/kg intramuscularly half to one hour prior to anesthesia or simultaneously with preanesthetic sedatives.

Drooling:

Under 3 years: Safety and efficacy not established.

3-16 years: 0.02 mg/kg orally every 8 hours initially and can be increased by 0.02 mg/kg every 5-7 days if needed; Max: 0.1 mg/kg every 8 hours.

Control of Secretions:

0.004-0.01 mg/kg IM/IV every 6 hours.

0.04-0.1 mg/kg orally every 6 hours.

Neuromuscular Blockade reversal:

0.2 mg IV for every 1 mg of neostigmine or 5 mg of pyridostigmine given.


Adverse Effect :

Urinary hesitancy and retention, cycloplegia, xerostomia, blurred vision and photophobia due to mydriasis (dilation of the pupil), increased ocular tension, palpitation, tachycardia, loss of taste, decreased sweating, nervousness, drowsiness, headache, weakness, insomnia, nausea, impotence, dizziness, vomiting, suppression of lactation, bloated feeling, constipation, severe allergic reactions including anaphylactic/anaphylactoid reactions, urticaria, hypersensitivity, dry skin, pruritus, mental confusion.


Interaction :

Phenothiazines, Antiparkinson Drugs, or Tricyclic Antidepressants: May intensify the antimuscarinic effects and may result in an increase in anticholinergic side effects.
Potassium Chloride: May increase the severity of potassium chloride-induced gastrointestinal lesions as a result of a slower gastrointestinal transit time.


08/10/2019 20:30:21 Glycopyrrolate
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