Glycopyrrolate (injection): Difference between revisions

Glycopyrrolate (injection)
	Adult Indications & Dosage
	Pediatric Indications & Dosage
	Contraindications
	Warnings & Precautions
	Adverse Reactions
	Drug Interactions
	Use in Specific Populations
	Administration & Monitoring
	Overdosage
	Pharmacology
	Clinical Studies
	How Supplied
	Images
	Patient Counseling Information
	Precautions with Alcohol
	Brand Names
	Look-Alike Names

VisualWikitext

Revision as of 18:29, 15 May 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]

Disclaimer

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Overview

Glycopyrrolate (injection) is an anticholinergic (antimuscarinic) agents that is FDA approved for the treatment of peptic ulcer when rapid anticholinergic effect is desired or when oral medication is not tolerated, it can also be used as a preoperative antimuscarinic. Common adverse reactions include flushing, constipation, and vomiting.

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Indications

In Anesthesia: Glycopyrrolate injection is indicated for use as a preoperative antimuscarinic to reduce salivary, tracheobronchial, and pharyngeal secretions; to reduce the volume and free acidity of gastric secretions; and, to block cardiac vagal inhibitory reflexes during induction of anesthesia and intubation. When indicated, glycopyrrolate injection may be used intraoperatively to counteract surgically or drug-induced or vagal reflexes associated arrhythmias. Glycopyrrolate protects against the peripheral muscarinic effects (e.g., bradycardia and excessive secretions) of cholinergic agents such as neostigmine and pyridostigmine given to reverse the neuromuscular blockade due to non-depolarizing muscle relaxants.

In Peptic Ulcer: For use in adults as adjunctive therapy for the treatment of peptic ulcer when rapid anticholinergic effect is desired or when oral medication is not tolerated.

Dosage

Preanesthetic Medication

The recommended dose of glycopyrrolate injection is 0.004 mg/kg by intramuscular injection, given 30 to 60 minutes prior to the anticipated time of induction of anesthesia or at the time the preanesthetic narcotic and/or sedative are administered.

Intraoperative Medication

Glycopyrrolate injection may be used during surgery to counteract drug-induced or vagal reflexes and their associated arrhythmias (e.g., bradycardia). It should be administered intravenously as single doses of 0.1 mg and repeated, as needed, at intervals of 2 to 3 minutes. The usual attempts should be made to determine the etiology of the arrhythmia, and the surgical or anesthetic manipulations necessary to correct parasympathetic imbalance should be performed.

Reversal of Neuromuscular Blockade

The recommended dose of glycopyrrolate injection is 0.2 mg for each 1.0 mg of neostigmine or 5.0 mg of pyridostigmine. In order to minimize the appearance of cardiac side effects, the drugs may be administered simultaneously by intravenous injection and may be mixed in the same syringe.

Peptic Ulcer

The usual recommended dose of glycopyrrolate injection is 0.1 mg administered at 4-hour intervals, 3 or 4 times daily intravenously or intramuscularly. Where more profound effect is required, 0.2 mg may be given. Some patients may need only a single dose, and frequency of administration should be dictated by patient response up to a maximum of four times daily.

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

There is limited information regarding Off-Label Guideline-Supported Use of Glycopyrrolate (injection) in adult patients.

Non–Guideline-Supported Use

There is limited information regarding Off-Label Non–Guideline-Supported Use of Glycopyrrolate (injection) in adult patients.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

Condition1

Dosing Information

Dosage

Condition2

There is limited information regarding FDA-Labeled Use of Glycopyrrolate (injection) in pediatric patients.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

Condition1

Developed by:

Class of Recommendation:

Strength of Evidence:

Dosing Information

Dosage

Condition2

There is limited information regarding Off-Label Guideline-Supported Use of Glycopyrrolate (injection) in pediatric patients.

Non–Guideline-Supported Use

Condition1

Dosing Information

Dosage

Condition2

There is limited information regarding Off-Label Non–Guideline-Supported Use of Glycopyrrolate (injection) in pediatric patients.

Contraindications

Condition1

Warnings

Description

Precautions

Description

Adverse Reactions

Clinical Trials Experience

There is limited information regarding Clinical Trial Experience of Glycopyrrolate (injection) in the drug label.

Body as a Whole

Cardiovascular

Digestive

Endocrine

Hematologic and Lymphatic

Metabolic and Nutritional

Musculoskeletal

Neurologic

Respiratory

Skin and Hypersensitivy Reactions

Special Senses

Urogenital

Miscellaneous

Postmarketing Experience

There is limited information regarding Postmarketing Experience of Glycopyrrolate (injection) in the drug label.

Body as a Whole

Cardiovascular

Digestive

Endocrine

Hematologic and Lymphatic

Metabolic and Nutritional

Musculoskeletal

Neurologic

Respiratory

Skin and Hypersensitivy Reactions

Special Senses

Urogenital

Miscellaneous

Drug Interactions

Drug

Description

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA):

Pregnancy Category

Pregnancy Category (AUS):

Australian Drug Evaluation Committee (ADEC) Pregnancy Category

There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Glycopyrrolate (injection) in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Glycopyrrolate (injection) during labor and delivery.

Nursing Mothers

There is no FDA guidance on the use of Glycopyrrolate (injection) with respect to nursing mothers.

Pediatric Use

There is no FDA guidance on the use of Glycopyrrolate (injection) with respect to pediatric patients.

Geriatic Use

There is no FDA guidance on the use of Glycopyrrolate (injection) with respect to geriatric patients.

Gender

There is no FDA guidance on the use of Glycopyrrolate (injection) with respect to specific gender populations.

Race

There is no FDA guidance on the use of Glycopyrrolate (injection) with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Glycopyrrolate (injection) in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Glycopyrrolate (injection) in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Glycopyrrolate (injection) in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Glycopyrrolate (injection) in patients who are immunocompromised.

Administration and Monitoring

Administration

Oral

Intravenous

Monitoring

There is limited information regarding Monitoring of Glycopyrrolate (injection) in the drug label.

Description

IV Compatibility

There is limited information regarding IV Compatibility of Glycopyrrolate (injection) in the drug label.

Overdosage

Acute Overdose

Signs and Symptoms

Description

Management

Description

Chronic Overdose

There is limited information regarding Chronic Overdose of Glycopyrrolate (injection) in the drug label.

Pharmacology

There is limited information regarding Glycopyrrolate (injection) Pharmacology in the drug label.

Mechanism of Action

Structure

File:Glycopyrrolate (injection)01.png

This image is provided by the National Library of Medicine.

Pharmacodynamics

There is limited information regarding Pharmacodynamics of Glycopyrrolate (injection) in the drug label.

Pharmacokinetics

There is limited information regarding Pharmacokinetics of Glycopyrrolate (injection) in the drug label.

Nonclinical Toxicology

There is limited information regarding Nonclinical Toxicology of Glycopyrrolate (injection) in the drug label.

Clinical Studies

There is limited information regarding Clinical Studies of Glycopyrrolate (injection) in the drug label.

How Supplied

Storage

There is limited information regarding Glycopyrrolate (injection) Storage in the drug label.

Images

Drug Images

{{#ask: Page Name::Glycopyrrolate (injection) |?Pill Name |?Drug Name |?Pill Ingred |?Pill Imprint |?Pill Dosage |?Pill Color |?Pill Shape |?Pill Size (mm) |?Pill Scoring |?NDC |?Drug Author |format=template |template=DrugPageImages |mainlabel=- |sort=Pill Name }}

Package and Label Display Panel

{{#ask: Label Page::Glycopyrrolate (injection) |?Label Name |format=template |template=DrugLabelImages |mainlabel=- |sort=Label Page }}

Patient Counseling Information

There is limited information regarding Patient Counseling Information of Glycopyrrolate (injection) in the drug label.

Precautions with Alcohol

Alcohol-Glycopyrrolate (injection) interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

GLYCOPYRROLATE ®^[1]

Look-Alike Drug Names

A® — B®^[2]

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

↑ "GLYCOPYRROLATE- glycopyrrolate injection, solution".
↑ "http://www.ismp.org". External link in |title= (help)

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[1] "GLYCOPYRROLATE- glycopyrrolate injection, solution".

[www.ismp.org-2] "http://www.ismp.org". External link in |title= (help)

[1]

[2]

@@ Line 5: / Line 5: @@
 |drugClass=[[anticholinergic]] ([[antimuscarinic]]) agents
 |indicationType=treatment
-|indication=[[peptic ulcer]] when rapid anticholinergic effect is desired or when oral medication is not tolerated, it can also be used as a preoperative antimuscarinic.
+|indication=[[peptic ulcer]] when rapid anticholinergic effect is desired or when oral medication is not tolerated, it can also be used as a preoperative antimuscarinic
 |adverseReactions=[[flushing]], [[constipation]], and [[vomiting]]
 |blackBoxWarningTitle=<span style="color:#FF0000;">ConditionName: </span>
@@ Line 15: / Line 15: @@
 <!--FDA-Labeled Indications and Dosage (Adult)-->
-|fdaLIADAdult======Condition1=====
+|fdaLIADAdult=====Indications====
-* Dosing Information
+*In Anesthesia: Glycopyrrolate injection is indicated for use as a preoperative antimuscarinic to reduce salivary, tracheobronchial, and pharyngeal secretions; to reduce the volume and free acidity of gastric secretions; and, to block cardiac vagal inhibitory reflexes during induction of anesthesia and intubation. When indicated, glycopyrrolate injection may be used intraoperatively to counteract surgically or drug-induced or vagal reflexes associated arrhythmias. Glycopyrrolate protects against the peripheral muscarinic effects (e.g., bradycardia and excessive secretions) of cholinergic agents such as neostigmine and pyridostigmine given to reverse the neuromuscular blockade due to non-depolarizing muscle relaxants.
-:* Dosage
+*In Peptic Ulcer: For use in adults as adjunctive therapy for the treatment of peptic ulcer when rapid anticholinergic effect is desired or when oral medication is not tolerated.
-=====Condition2=====
+====Dosage====
-* Dosing Information
+=====Preanesthetic Medication=====
-:* Dosage
+The recommended dose of glycopyrrolate injection is 0.004 mg/kg by intramuscular injection, given 30 to 60 minutes prior to the anticipated time of induction of anesthesia or at the time the preanesthetic narcotic and/or sedative are administered.
-=====Condition3=====
+=====Intraoperative Medication=====
-* Dosing Information
+Glycopyrrolate injection may be used during surgery to counteract drug-induced or vagal reflexes and their associated arrhythmias (e.g., bradycardia). It should be administered intravenously as single doses of 0.1 mg and repeated, as needed, at intervals of 2 to 3 minutes. The usual attempts should be made to determine the etiology of the arrhythmia, and the surgical or anesthetic manipulations necessary to correct parasympathetic imbalance should be performed.
-:* Dosage
+=====Reversal of Neuromuscular Blockade=====
-=====Condition4=====
+The recommended dose of glycopyrrolate injection is 0.2 mg for each 1.0 mg of neostigmine or 5.0 mg of pyridostigmine. In order to minimize the appearance of cardiac side effects, the drugs may be administered simultaneously by intravenous injection and may be mixed in the same syringe.
-* Dosing Information
+=====Peptic Ulcer=====
-:* Dosage
+The usual recommended dose of glycopyrrolate injection is 0.1 mg administered at 4-hour intervals, 3 or 4 times daily intravenously or intramuscularly. Where more profound effect is required, 0.2 mg may be given. Some patients may need only a single dose, and frequency of administration should be dictated by patient response up to a maximum of four times daily.
-<!--Off-Label Use and Dosage (Adult)-->
+|offLabelAdultGuideSupport=There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of {{PAGENAME}} in adult patients.
-<!--Guideline-Supported Use (Adult)-->
-|offLabelAdultGuideSupport======Condition1=====
-* Developed by:
+|offLabelAdultNoGuideSupport=There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of {{PAGENAME}} in adult patients.
-* Class of Recommendation:
-* Strength of Evidence:
-* Dosing Information
-:* Dosage
-=====Condition2=====
-There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of {{PAGENAME}} in adult patients.
-<!--Non–Guideline-Supported Use (Adult)-->
-|offLabelAdultNoGuideSupport======Condition1=====
-* Dosing Information
-:* Dosage
-=====Condition2=====
-There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of {{PAGENAME}} in adult patients.
-<!--Pediatric Indications and Dosage-->
 <!--FDA-Labeled Indications and Dosage (Pediatric)-->