Glycopyrrolate

Chemical

Synthetic quaternary ammonium compound

Use

Anti-sialogogue

Counter muscarinic effects of anticholinesterases

Presentation

Clear solution for injection 0.2mg/mL

Dose

200 – 400mcg

Route

IV

Onset

Slow (2-4mins)

DoA (Duration)

2-4hrs – well paired to Neostigmine

MoA

Competitive antagonist of ACh at peripheral muscarinic receptors

PD

CVS

↑HR (atropine > buscopan > glycopyrrolate)

METABOLIC

Inhibits sweating

RESP

Bronchodilation

↓resp secretion (buscopan > glycopyrrolate > atropine)

GI

(Buscopan > glycopyrrolate > atropine)

Powerful anti-sialogogue

↓gastric secretions

↓LOS

PK

A

Poor absorption, OBA 5%

D

Rapid redistribution, 90% disappears from plasma in 5 min

Crosses placenta → foetal brady

VD 0.2 – 0.6L/kg

M

None

E

Excreted in urine (85%) & bile (15%)

Adverse Effects

Dry mouth

Urinary retention

Inhibition of sweating