Usage And Safety
Dosage
Pyrolate (Glycopyrrolate Injection USP) may be administered intramuscularly or intravenously without dilution for the following: a) Pre-Anaesthetic Medication Prophylaxis of excessive salivation and respiratory tract secretions. Adults: 4.4µg (0.0044 mg) per kg of body weight, one-half to one hour before induction of anaesthesia or at the time when the pre-anaesthetic narcotic or sedative are administered. Children: Intramuscular 4.4 to 8.8µg (0.0044 to 0.0088mg) per kg of body weight, one-half to one hour before induction of anaesthesia. Infants: 1 Month to 2 years may require upto 0.009ml/kg dose b) Intraoperative Medication Counteract arrhythmias during surgery. Adults: Intravenous 100µg (0.1 mg), the dosage being repeated, if necessary at two to three minutes interval. Children: Intravenous 4.4µg (0.0044mg) per kg of body weight upto a maximum of 100µg (0.1mg), the dosage being repeated, if necessary, at two to three minutes intervals. c) Reversal of Neuromuscular Block (Non-Depolarizing Type) Adults: Intravenous 200µg (0.2 mg), for each 1mg of neostigmine or 5 mg of pyridostigmine given simultaneously. Note: In old age patients, the dose to be adjusted accordingly. Children: Intravenous 200µg (0.2 mg) for each,1 mg of neostigmine or 5mg pyridostigmine given simultaneously.
Side Effects
Anti-cholinergics produce certain side effects most of which are extension of their pharmacological actions; they include: dry mouth, urinary retention, blurred vision, tachycardia, decreased sweating, loss of taste, headache, drowsiness, weakness, nausea, vomiting, suppression of lactation, constipation, allergic reactions and some degree of mental confusion or excitement.
Drug Interactions
Amantadine , cyclopropane , anticholinergic agents , levodopa .
Indication
INDICATIONS: a) Anti-Muscarinic l Pyrolate (Glycopyrrolate Injection USP) is indicated for use as a pre-operative, anti-muscarinic drug to reduce salivary, tracheo-bronchial, and pharyngeal secretions. l To reduce the volume of free gastric acid and to raise pH of gastric contents above 2.5. l It also blocks cardiac vagal inhibitory reflexes during induction and intubation. b) Anti -Arrhythmic Pyrolate (Glycopyrrolate Injection USP) may be used intra-operatively to counteract drug induced or vagal traction reflexes with associated arrhythmias. c) Reversal of Neuromuscular Blockade Pyrolate (Glycopyrrolate Injection USP) is indicated to reverse the neuromuscular block produced by non-depolarizing neuromuscular blocking agents, in combination with Neo-choline (Neostigmine) and pyridostigmine.
When not to Use
Known hypersensitivity to glycopyrrolate . Due to its benzyl alcohol content, Pyrolate should not be used in newborn or children less than 1 month of age. . Concurrent glaucoma. . Obstructive diseases of the gastrointestinal tract (as in achalasia, pyloroduodenal stenosis) . Paralytic ileus, intestinal atony. Un-stable cardiovascular status in acute haemorrhage. Severe ulcerative colitis. Myasthenia gravis.
Warnings
Warning 1
Use with caution in patients with coronary artery disease, congestive heart failure, hypertension and hyperthyroidism .
Warning 2
Due to its benzyl alcohol content, Pyrolate should not be used in newborn or children less than 1 month of age.
Warning 3
Un-stable cardiovascular status in acute haemorrhage .
