Home Drug Guide Glycopyrrolate

Drug Guide

Generic Name

Glycopyrrolate

Brand Names Robinul, Robinul Forte, Cuvposa, Seebri, Lonhala Magnair Kit, Glyrx-pf, Dartisla Odt

Classification

Therapeutic: Anticholinergic agent

Pharmacological: Muscarinic receptor antagonist

FDA Approved Indications

Preoperative control of secretions in airway management
Peptic ulcer disease (off-label in some cases)
Management of excessive salivation (sialorrhea)

Mechanism of Action

Glycopyrrolate competitively inhibits muscarinic acetylcholine receptors, reducing secretions and gastrointestinal motility.

Dosage and Administration

Adult: For preoperative secretions: 0.2 mg IV or IM; may repeat every 30-60 min as needed. For sialorrhea: 1-2 mg orally 2-3 times daily.

Pediatric: Doses vary by age and indication; for sialorrhea, typically 0.02-0.04 mg/kg orally, divided doses.

Geriatric: Start at lower end of dosing range due to increased sensitivity.

Renal Impairment: Use with caution; adjust dose based on severity.

Hepatic Impairment: No specific adjustments recommended; monitor closely.

Pharmacokinetics

Absorption: Absorbed rapidly after IM or IV administration; oral absorption variable.

Distribution: Widely distributed, crosses the blood-brain barrier to a limited extent.

Metabolism: Metabolized partially in the liver.

Excretion: Primarily excreted unchanged in urine.

Half Life: Approximately 2-3 hours.

Contraindications

Glaucoma (narrow-angle)
Obstructive uropathy
Myasthenia gravis
Known hypersensitivity to glycopyrrolate

Precautions

Use with caution in patients with tachycardia, GI obstruction, or hepatic impairment.
Pregnancy Category C; use only if clearly needed.
Lactation: caution advised; consider risks and benefits.

Adverse Reactions - Common

Dry mouth (Common)
Blurred vision (Common)
Urinary retention (Common)
Constipation (Common)

Adverse Reactions - Serious

Tachycardia or arrhythmias (Uncommon)
Anaphylaxis (Rare)
Acute narrow-angle glaucoma (Rare)

Drug-Drug Interactions

Other anticholinergic agents (additive effects)
AChE inhibitors (antagonistic interaction)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor respiratory status, secretions, heart rate, urinary output, and bowel function.

Diagnoses:

Risk for impaired comfort due to dry mouth or vision changes
Risk for urinary retention

Implementation: Administer as directed, monitor for adverse effects, educate patient about dry mouth management.

Evaluation: Assess reduction in secretions and relief of symptoms, monitor for adverse reactions.

Patient/Family Teaching

Take medication exactly as prescribed.
Report new or worsening symptoms, especially urinary retention, vision changes, or severe dry mouth.
Maintain hydration and good oral hygiene.
Avoid activities requiring alertness until response is known.

Special Considerations

Black Box Warnings:

No black box warnings issued.

Genetic Factors: None specified.

Lab Test Interference: May affect certain diagnostic tests involving urine or secretions.

Overdose Management

Signs/Symptoms: Severe dry mouth, blurred vision, hot dry skin, hallucinations, tachycardia, urinary retention.

Treatment: Supportive care, activated charcoal if ingestion is recent, and measures to reduce body temperature. Physostigmine may be considered in severe cases under medical supervision.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable under recommended conditions for shelf life specified by manufacturer.