Glycopyrrolate: Difference between revisions
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==Administration== | ==Administration== | ||
* | *Class: [[Anticholinergics]] | ||
*Routes of Administration: Oral, IV, IM | |||
*Routes of Administration: Oral, IM, | *Dosage Forms: 1-2 mg tablets, 1 mg/5mL oral solution, 0.2 mg/mL injectable solution | ||
*Common Trade Names: Robinul | *Common Trade Names: Robinul, Cuvposa | ||
==Adult Dosing== | ==Adult Dosing== | ||
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***Start: 1 mg PO tid | ***Start: 1 mg PO tid | ||
***Max: 8 mg/day | ***Max: 8 mg/day | ||
**IM/IV Dose: 0.1-0.2 mg IM/IV tid- | **IM/IV Dose: 0.1-0.2 mg IM/IV tid-QID | ||
***Max: 0.8 mg/day | ***Max: 0.8 mg/day | ||
***Space dose 4h apart | ***Space dose 4h apart | ||
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**PO Dose: 1-2 mg PO bid-tid; | **PO Dose: 1-2 mg PO bid-tid; | ||
***Max: 8 mg/day | ***Max: 8 mg/day | ||
**Parenteral Dose: 0.1-0.2 mg SC/IM/IV q4-8h | **Parenteral Dose: 0.1-0.2 mg SC/IM/IV q4-8h PRN | ||
***Max: 0.8 mg/day | ***Max: 0.8 mg/day | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
*Antisialagogue | *Antisialagogue | ||
**PO Dose, 2+ yo: 0.04-0.1 mg/kg PO q4-8h | **PO Dose, 2+ yo: 0.04-0.1 mg/kg PO q4-8h PRN | ||
***Max: 1-2 mg/dose, 8mg/day | ***Max: 1-2 mg/dose, 8mg/day | ||
**Parenteral Dose, 2+ yo: 0.0004-0.01 mg/kg SC/IM/IV q4-8h | **Parenteral Dose, 2+ yo: 0.0004-0.01 mg/kg SC/IM/IV q4-8h PRN | ||
***Max: 0.1-0.2 mg/dose, 0.8 mg/day | ***Max: 0.1-0.2 mg/dose, 0.8 mg/day | ||
==Special Populations== | ==Special Populations== | ||
*[[Drug pregnancy categories|Pregnancy Rating]]: B; No known risk of teratogenicity | *[[Drug pregnancy categories|Pregnancy Rating]]: B; No known risk of teratogenicity with INJ form at 5x MRHD and with PO form at 320x MRHD | ||
*Lactation risk: L3; Safety unknown | *Lactation risk: L3; Safety unknown | ||
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*Intestinal atony in elderly, debilitated pts | *Intestinal atony in elderly, debilitated pts | ||
*[[Myasthenia gravis]] | *[[Myasthenia gravis]] | ||
*Acute hemorrhage | *Acute hemorrhage with unstable cardiovascular status | ||
*Caution if CAD | *Caution if CAD | ||
*Caution if [[HTN]] | *Caution if [[HTN]] | ||
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*Caution if [[febrile]] | *Caution if [[febrile]] | ||
*Caution if [[ulcerative colitis]] | *Caution if [[ulcerative colitis]] | ||
*Caution if hiatal hernia | *Caution if hiatal hernia with reflux [[esophagitis]] | ||
==Adverse Reactions== | ==Adverse Reactions== | ||
Latest revision as of 17:14, 6 May 2022
Administration
- Class: Anticholinergics
- Routes of Administration: Oral, IV, IM
- Dosage Forms: 1-2 mg tablets, 1 mg/5mL oral solution, 0.2 mg/mL injectable solution
- Common Trade Names: Robinul, Cuvposa
Adult Dosing
- PUD, adjunct tx
- PO Dose: 1-2 mg PO bid-tid;
- Start: 1 mg PO tid
- Max: 8 mg/day
- IM/IV Dose: 0.1-0.2 mg IM/IV tid-QID
- Max: 0.8 mg/day
- Space dose 4h apart
- PO Dose: 1-2 mg PO bid-tid;
- Antisialagogue
- PO Dose: 1-2 mg PO bid-tid;
- Max: 8 mg/day
- Parenteral Dose: 0.1-0.2 mg SC/IM/IV q4-8h PRN
- Max: 0.8 mg/day
- PO Dose: 1-2 mg PO bid-tid;
Pediatric Dosing
- Antisialagogue
- PO Dose, 2+ yo: 0.04-0.1 mg/kg PO q4-8h PRN
- Max: 1-2 mg/dose, 8mg/day
- Parenteral Dose, 2+ yo: 0.0004-0.01 mg/kg SC/IM/IV q4-8h PRN
- Max: 0.1-0.2 mg/dose, 0.8 mg/day
- PO Dose, 2+ yo: 0.04-0.1 mg/kg PO q4-8h PRN
Special Populations
- Pregnancy Rating: B; No known risk of teratogenicity with INJ form at 5x MRHD and with PO form at 320x MRHD
- Lactation risk: L3; Safety unknown
Renal Dosing
- Adult: Not defined; consider decreased dose.
- Pediatric: No defined; consider decreased dose.
Hepatic Dosing
- Adult: Not defined.
- Pediatric: Not defined.
Contraindications
- Allergy to class/drug
- Neonates (benzyl alcohol-containing INJ forms)
- Glaucoma, angle-closure
- Obstructive uropathy
- GI Obstruction
- Paralytic ileus
- Toxic megacolon
- Ulcerative colitis, severe
- Intestinal atony in elderly, debilitated pts
- Myasthenia gravis
- Acute hemorrhage with unstable cardiovascular status
- Caution if CAD
- Caution if HTN
- Caution if CHF
- Caution if arrhythmia
- Caution in elderly/debilitated pts
- Caution if renal impairment
- Caution if pulmonary disease
- Caution if hyperthyroidism
- Caution if autonomic neuropathy
- Caution if BPH
- Caution if high environmental temperature
- Caution if febrile
- Caution if ulcerative colitis
- Caution if hiatal hernia with reflux esophagitis
Adverse Reactions
Serious
- Hypersensitivity reaction
- Anaphylaxis
- Intestinal obstruction
- Heat stroke
- Seizure
- Arrhythmia
- Cardiac arrest
- Respiratory arrest
Common
- Xerostomia
- Vomiting
- Constipation
- Flushing
- Headache
- Urinary retention
- Urinary hesitancy
- Blurred vision
- Palpation
- Tachycardia
- Anhidrosis
- Dysgeusia
- Lactation suppression
Pharmacology
- Half-life: 0.83h
- Metabolism: Unknown
- Excretion: Urine 85%, bile
Mechanism of Action
- Antagonizes acetylcholine receptors.