GLYCOPYRRONIUM BROMIDE

Glycopyrronium bromide is a medication of the muscarinic anticholinergic team. It does not cross the blood–brain barrier and as a consequence has no to few central effects. As an artificial quaternary amine, it is in oral and intravenous forms and as inhalation.

Glycopyrronium is a synthetic anticholinergic agent with a quaternary ammonium structure. It is a muscarinic aggressive antagonist used as an antispasmodic, in some issues of the gastrointestinal tract, and to lessen salivation with some anesthetics.

Uses

Glycopyrronium bromide is used in conjunction with neostigmine, a neuromuscular blockading reversal agent, to preclude neostigmine’s muscarinic results like bradycardia. It is usually used to minimize excessive saliva (sialorrhea), and Ménière’s disorder.

This drug is used as a preoperative antimuscarinic to shrink salivary, tracheobronchial, and pharyngeal secretions, to decrease the volume and free acidity of gastric secretions and to block cardiac vagal inhibitory reflexes throughout induction of anesthesia and intubation. Additionally, it is used to deal with chronic obstructive pulmonary ailment (COPD).

Warnings

In the presence of a high environmental temperature, heat prostration (fever and heat stroke as a result of reduced sweating) can arise with use of Glycopyrronium Bromide oral solution. Due to prolongation of renal elimination, repeated or larger doses of Glycopyrronium Bromide should be avoided in patients with uraemia

The use of this drug should be avoided in the following:

Hypersensitivity
Glaucoma
Obstructive uropathy
Obstructive GI diseases
Intestinal atony
Paralytic ileus
Pyloric stenosis
Myasthenia gravis
Unstable CV status in acute haemorrhage

Injectable is not recommended in new borns ≤1 month if benzyl alcohol is present in the preparation.

Side Effects

These may cause allergies (probably delayed).

Glycopyrronium Bromide shouldn’t be used in children.

Many medicines have antimuscarinic results; concomitant use of two or more of such medicinal drugs can increase side effects such as dry mouth, urine retention and constipation.

Precautions

Precautions

Special precautions should be observed with the following:

Pregnancy
Lactation
Cardiovascular disease
Hyperthyroidism
Hepatic or renal impairment
Enlarged prostate
Diarrhoea
Fever
This drug may cause ileus or megacolon in patients with ulcerative colitis
Children and elderly

Interactions

This drug decreases levodopa effects. Effects may be enhanced by using drugs with antimuscarinic properties or MAOIs concurrently.

This drug may antagonise the GI effects of cisapride, metoclopramide and dompeidone.

Potentially Fatal: IV administration in the presence of cyclopropane anesthesia can result in ventricular arrhythmias.

Overdose & Brands

Glycopyrronium overdose may result in anticholinergic signs and symptoms for which symptomatic treatment may be indicated.

Acute intoxication by inadvertent oral ingestion of Seebri Breezhaler capsules is unlikely due to the low oral bioavailability (about 5%).

Available Brands:

Glycoair Breezhaler, Seebri Breezhaler, Ultibro Breezhaler