Glycopyrrolate

Details About Generic Salt ::  Glycopyrrolate 

Main Medicine Class:: Gastrointestinal System   Sub Medicine Class ::  GERD,

7A. GERD, ULCER/ANTACIDS in 7. GASTROINTESTINAL SYSTEM
GLYCOPYRROLATE
QUATERNARY AMMONIUM DERIVATIVE | ANTI-MUSCARINIC
also comes under 16C. Miscellaneous in 16. Anesthetics,  
PK: A: Poor & erratic D: Children: 1.3-1.8L/kg; Adults: 0.2-0.62L/kg (Vd) M: Hepatic E: Urine

Indications & Dose: CONTROL OF UPPER AIRWAYS SECRETION/DROOLING PO Child 1 month-18 yr: 40-100µg/kg, max 2mg TID/QID | SC Child Inf: 1 month-12 yr: 12-40µg/kg/day, max 1.2mg, 12-18 yr: 0.6-1.2mg/day | PEPTIC ULCER PO Adult Initially 3-6mg/day in divided doses, max 8mg/day, MD 1mg BID | IV/IM Adult 0.1-0.2mg TID/QID | PREMEDICATION AT INDUCTION IV/IM Adult 200-400µg before the induction of anesthesia Child Neonate: 5µg/kg; 1 month-12 yr: 4-8µg/kg, max 200µg, 12-18 yr: 200-400µg or 4-5µg/kg, max 400µg | REDUCTION OF SECRETIONS IV Adult Intra-operative: 0.1mg repeated as needed at 2-3min intervals Child 4µg/kg, max 0.1mg repeated as needed at 2-3min intervals | Pre-operative prophylaxis IM Adult 4µg/kg 30-60 min before procedure Child <2 yr: 4-9µg/kg 30-60 min before procedure; >2 yr: 4µg/kg 30-60 min before procedure | REVERSE NEUROMUSCULAR BLOCKADE IV Adult 5-15µg/kg with 25-70µg/kg of neostigmine or 0.1-0.3mg/kg of pyridostigmine (drugs usually administered simultaneously, but glycopyrrolate may be administered first if bradycardia is present) Child Same as adult dose

Contra: Hypersensitivity, severe UC, toxic megacolon complicating UC, paralytic ileus, pyloric stenosis, intestinal atony in elderly/debilitated patient, unstable CV status, narrow-angle glaucoma, acute hemorrhage, tachycardia, obstructive uropathy, myasthenia gravis, obstructive GI disease, hepatic/renal disease, asthma, thyrotoxicosis, prostatic enlargement

Precautions: CVD, renal impairment, hiatal hernia, hyperthyroidism, neuropathy, prostatic hyperplasia, children, elderly, diarrhea/fever

ADR: Serious: Malignant hyperthermia, intestinal obstruction, anaphylaxis, arrhythmias, cardiac arrest, heart block, hyper-/hypotension, tachycardia, seizure, blurred vision, ocular tension increased, pneumonia, respiratory depression, Others: bronchial secretion, nasal dryness, dry skin, rash, dehydration, lactation suppression, abdominal distention, nausea, UTI, impotence, urinary hesitancy, Inj site reactions, weakness, nystagmus, mood changes, restlessness, confusion, drowsiness, insomnia, nervousness, flushing, headache, vomiting, xerostomia, constipation, urinary retention, nasal congestion, sinusitis, URTI

DDI: Serious Alcohol leads to marked impairment of attention

Diet: 1h before/2h after food

Monitor: HR, anticholinergic effects, bowel sounds & movements, effects on drooling

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