Glycopyrrolate review

Glycopyrrolate is also known as Glycopyrronium. It is a synthetic drug belonging to a group of drugs called Pyrolidines. It is a cholinergic muscarinic antagonist drugs. It is generally classified as an anticholinergic and anti-spasmodic drug.

Glycopyrrolate, which is also known as robinul, is available as an intravenous drug. It is used for the treatment as an anesthetic, or a preoperative antimuscarinic drug that reduces saliva, and secretions from the tracheobronchial and pharyngeal area. It may also be used as an adjunctive therapy for peptic ulcer management.

The dosage of the drug varies for adults, pediatric and neo-natal patients. The usual dose of robinul as a pre-anesthetic for adults is 0.004 mg/kg of body weight. For pediatric patients, the usual dose of robinul as a pre-anesthetic is at 0.004 mg/kg of body weight. The drug should be given within 30 to 60 minutes before the operation, or at the time the narcotic/sedative is administered. Robinul is not recommended for infants, however, as needed, the dosage may be at 0.009 mg/kg of weight, and must not exceed 0.01mg.

For the treatment of peptic ulcer, the recommended dose of glycopyrrolate for adults is 0.1mg taken at 4-hour intervals through intravenous or intramuscular injections. The use of the drug to treat peptic ulcers in infants and pediatric patients is not recommended.

Side effects such as allergic reactions (hives, swelling of injection sites, reactions) may occur when the drug is taken. However, these are rarely occurring. The more common side effects reported appear similar with other anticholinergics, such as xerostomia (dry mouth), urinary retention, dilation of the pupils, increased sweating, headaches, loss of appetite, weight gain/loss, vomiting, nausea, dizziness, weakness, dry skin and even mental confusion.

More serious side effects, such as impotence, hyperthermia, irregular heartbeats, cardiac arrests, seizures, tachycardia and even respiratory seizures may also occur.

Glycopyrrolate is contraindicated in patients with a known hypersensitivity to the drug or its known components. It is also contraindicated in patients with known heart, liver, sensory and kidney conditions, including, but are not limited to glaucoma, obstructive uropathy and achalasia.

As glucopyrrolate is combined with benzyl alcohol, the use of the drug in infants and neonatal has to be done with extreme caution as it may result in toxicity and an increase in the incidence of kernicterus.

Caution is to be exercised upon taking the drug as it may cause blurred vision and/or drowsiness. Activities requiring mental focus and alertness such as driving, or machine operation must be refrained from when taking this drug. Patients less than a month old are not recommended to use the drug.

An increase in body temperature of the use may result in the occurrence of heat prostration, which may result to heat strokes if not addressed properly.

It is not known whether glycopyrrolate has adverse effects to the fetus. However, the use of the drug in pregnant women should always be consulted with the doctor.

Nursing mothers, or women planning to breastfeed must first consult their doctor prior to the usage of the drug. The potential benefits of the drug must always be weighed against its risks to the nursing mother and infant. Similar with other anticholinergics, glycopyrrolate may cause the suppression of lactation in nursing mothers.

Glycopyrrolate has the following structural formula:

Chemical structure of glycopyrrolate

• Molecular formula of glycopyrrolate is C19H28NO3+
• Chemical IUPAC Name is (1,1-dimethyl-2,3,4,5-tetrahydropyrrol-3-yl) 2-cyclopentyl-2-hydroxy-2-phenyl-acetate
• Molecular weight is 318.431 g/mol
Glycopyrrolate available : 1ml injection

Brand name(s): Asecryl, Gastrodyn, Nodapton, Robanul, Robinal, Robinul, Tarodyl, Tarodyn

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