Glycopyrrolate anticholinergic

Anticholinergics (cholinergic blocking drug) reduce gastric motility and decrease the amount of acid secreted by the stomach (see Chap. 25). Examples of anticholinergics used for GI disorders include propantheline (Pro-Banthine) and glycopyrrolate (Robinul). 

Geriatric Considerations - Summary Glycopyrrolate does not cross the blood-brain barrier so is less likely to cause the central effects seen with anticholinergics such as atropine. Other anticholinergic side effects such as blurred vision, dry mouth, urinary retention, and constipation do occur and can limit the usefulness of this drug in the older adult. 

Anticholinergics Prevent excessive salivation and respiratory tract secretions Atropine Glycopyrrolate Scopolamine Oral 2 mg IM 0.2-0.6 mg 30 to 60 minutes before surgery IM 0.0044 mg/kg body weight 30 to 60 minutes before induction of anesthesia IM 0.2-0.6 mg 30 to 60 minutes before induction of anesthesia... 

Anticholinergic agents are only effective in controlling vagal-mediated bradyarrhythmias and, as such, are usually only used to treat or prevent life-threatening bradycardia during anesthesia. Atropine and glycopyrrolate are used most... 

For soft anticholinergics, the inactive metabolite-based approach can also yield a different class of compounds in which the hydrolytically labile ester-containing side-chain is attached to the quaternary nitrogen head (69). A few such compounds derived from methylatropine (71) (186) or glycopyrrolate... 

Additional studies were performed with several subjects who exhibited a uricosuric response to glycopyrrolate. In order to ascertain whether other anticholinergic agents were capable of producing a uricosuric response, a second anticholinergic, tridi-... 

If cuff deflation is complicated by sialorrhea anticholinergic medications, such as scopolamine, glycopyrrolate, or amitriptyline may be used. Sublingual, 1% ophthalmic atropine, 1 to 4 drops up to q.i.d. is also effective (65), unless narrow angle closure glaucoma is present. 

Intranasal anticholinergics effectively reduce rhinorrhea. Ipratropium bromide, oxitropium bromide, tiotpropium bromide, and glycopyrrolate are quaternary structured ammonium muscarinic receptor antagonists, which are poorly absorbed into the systemic circulation. They reduce nasal secretions by influence on submucosal glands innervated by parasympathetic nerves (74). Intranasal anticholinergics are ineffective for control of allergic rhinitis symptoms other than rhinorrhea (74). 

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