Glycopyrrolate(glye koe pye’ roe late)
Cuvposa, Robinul, Robinul Forte
PREGNANCY CATEGORY B
Drug Classes
Anticholinergic (quaternary)
Antimuscarinic
Antispasmodic
Parasympatholytic
Therapeutic Actions
Competitively blocks the effects of acetylcholine at receptors that mediate the effects of parasympathetic postganglionic impulses; depresses salivary and bronchial secretions; dilates the bronchi; inhibits vagal influences on the heart; relaxes the GI and GU tracts; inhibits gastric acid secretion.
Indications
Oral: Adjunctive therapy in the treatment of peptic ulcer
Oral solution: Treatment of chronic, severe drooling caused by neurologic disorders in children 3–16 yr
Parenteral: Reduction of salivary, tracheobronchial, and pharyngeal secretions preoperatively; reduction of the volume and free acidity of gastric secretions; and blocking of cardiac vagal inhibitory reflexes during induction of anesthesia and intubation; may be used intraoperatively to counteract drug-induced or vagal traction reflexes with the associated arrhythmias
Parenteral: Protection against the peripheral muscarinic effects (eg, bradycardia, excessive secretions) of cholinergics (neostigmine, pyridostigmine) that are used to reverse the neuromuscular blockade produced by nondepolarizing neuromuscular junction blockers
Contraindications and Cautions
Contraindicated with glaucoma; adhesions between iris and lens; stenosing peptic ulcer; pyloroduodenal obstruction; paralytic ileus; intestinal atony; severe ulcerative colitis; toxic megacolon; symptomatic prostatic hypertrophy; bladder neck obstruction; bronchial asthma; COPD; cardiac arrhythmias; tachycardia; myocardial ischemia; lactation; impaired metabolic, liver, or kidney function; myasthenia gravis.
Use cautiously in the elderly and with Down syndrome, brain damage, spasticity, hypertension, hyperthyroidism, pregnancy.
Available Forms
Tablets—1, 2, mg; injection—0.2 mg/mL; oral solution—1 mg/5 mL
Dosages
Adults
Oral
1 mg tid or 2 mg bid–tid. For maintenance, 1 mg bid. Maximum daily dose is 8 mg PO.
Parenteral
Peptic ulcer: 0.1–0.2 mg IM or IV tid–qid.
Preanesthetic medication: 0.004 mg/kg IM 30–60 min before anesthesia.
Intraoperative: 0.1 mg IV; repeat as needed at 2- to 3-min intervals.
Reversal of neuromuscular blockade: With neostigmine, pyridostigmine: 0.2 mg for each 1 mg neostigmine or 5 mg pyridostigmine; administer IV simultaneously.
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