Pyrolate Injection
Glycopyrrolate
0.2mg
Neon Laboratories Ltd
| Pack size | 10's |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 19.12 NPR |
Indications
Pyrolate Injection is used for:
In Anesthesia:
• As a pre-operative antimuscarinic agent to reduce salivary, tracheobronchial and pharyngeal sections and to reduce the acidity of the gastric contents.
• As a pre-operative or intra-operative antimuscarinic to attenuate or prevent intra-operative bradycardia with the use of suxamethonium or due to cardiac vagal reflexes.
• To protect against the peripheral muscarinic actions of anticholinesterases such as neostigmine and pyridostigmine, used to reverse residual neuromuscular blockade produced by non- depolarising 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.
Hyperhidrosis, Sialorrhea, Cerebral palsy.
Adult Dose
Parenteral
Reduction of secretions
Adult: Preoperative: 4 mcg/kg via IM admin 30-60 minutes before procedure.
Intraoperative: 0.1 mg via IV admin, repeat at 2-3 minute intervals when needed. Max: 400 mcg/dose.
Intravenous
Reversal of neuromuscular blockade
Adult: 200 mcg for each 1 mg of neostigmine or 5 mg of pyridostigmine. Alternatively, 5-15 mcg/kg with 50 mcg/kg neostigmine with 25-70 mcg/kg of neostigmine or 0.1-0.3 mg/kg of pyridostigmine.
Parenteral
Peptic ulcer
Adult: 0.1-0.2 mg 3-4 times daily via IM/IV admin.
Child Dose
Parenteral
Reduction of secretions
Child: Preoperative: IM admin: <2 yr: 4-9 mcg/kg; >2 yr: 4 mcg/kg, dose to be given 30-60 minutes before procedure.
Intraoperative: IV admin: 4 mcg/kg (Max: 0.1 mg); repeat at 2-3-minute intervals as needed.
Max Dosage: Child >1 mth: 200 mcg/dose.
Intravenous
Reversal of neuromuscular blockade
Child: 10 mcg/kg with 50 mcg/kg neostigmine.
Renal Dose
Administration
Contra Indications
Angle-closure glaucoma; myasthenia gravis (large doses of quaternary ammonium compounds have been shown to block end plate nicotinic receptors); paralytic ileus; pyloric stenosis; prostatic enlargement. Anticholinesterase-antimuscarinic combinations such as neostigmine plus glycopyrronium should be avoided in patients with a prolonged QT interval.
Precautions
Antimuscarinics should be used with caution (due to increased risk of side effects) in Down’s syndrome, in children and in the elderly.
They should also be used with caution in gastro-esophageal reflux disease, diarrhea, ulcerative colitis, acute myocardial infarction, hypertension, conditions characterized by tachycardia (including hyperthyroidism, cardiac insufficiency, cardiac surgery) because of the increase in heart rate produced by their administration, coronary artery disease and cardiac arrhythmias, pyrexia (due to inhibition of sweating), pregnancy and breast feeding.
Because of prolongation of renal elimination, repeated or large doses of glycopyrronium bromide should be avoided in patients with uremia.
Large doses of quaternary anticholinergic compounds have been shown to block end plate nicotinic receptors. This should be considered before using glycopyrrolate in patients with myasthenia gravis.
It is known that the administration of anticholinergic agents during inhalation anesthesia can result in ventricular arrhythmias.
Lactation: Excretion in milk unknown; use with caution
Pregnancy-Lactation
Interactions
Decreases levodopa effects. Effects may be enhanced by using drugs with antimuscarinic properties or MAOIs concurrently. May antagonise the GI effects of cisapride, metoclopramide and dompeidone.
Potentially Fatal: IV admin in the presence of cyclopropane anesth can result in ventricular arrhythmias.
Adverse Effects
Side effects of Glycopyrrolate :
Anticholinergic symptoms (mydriasis, hyperthermia, tachycardia, cardiac arrhythmia),Dry mouth,Dry skin,Anhidrosis,Flushing,Blurred vision,Cycloplegia,Photophobia,Palpitation,Xerophthalmia,Constipation,Urinary retention
Potentially Fatal: Severe anaphylaxis.
Mechanism of Action
Glycopyrronium bromide is a quarternary ammonium antimuscarinic. It blocks acetylcholine at parasympathomimetic sites and induces smooth muscle relaxation. It also reduces gastric acid secretions and controls pharyngeal, tracheal and bronchial secretions. It antagonises muscarinic symptoms such as bronchorrhoea, bronchospasm, bradycardia and intestinal hypermotility induced by anticholinesterases.
Note
Pyrolate 0.2mg Injection manufactured by Neon Laboratories Ltd. Its generic name is Glycopyrrolate. Pyrolate is availble in Nepal.
Farmaco Nepal drug index information on Pyrolate Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.