Supotaria 0.6

• Pre-operative antimuscarinic agent: to reduce salivary, tracheobronchial and pharyngeal secretions and to reduce gastric acidity
• Intra-operative antimuscarinic: to attenuate or prevent bradycardia due to suxamethonium or cardiac vagal reflexes
• Reversal of neuromuscular blockade: to protect against peripheral muscarinic actions of neostigmine and pyridostigmine
• Peptic Ulcer: adjunctive therapy in adults

Glycopyrronium bromide is a quaternary ammonium antimuscarinic with peripheral effects. It is used in anesthetic practice. Given as a premedication before general anesthesia, it diminishes the risk of vagal inhibition of the heart and reduces salivary and bronchial secretions. Intra-operatively, it may be given to reduce bradycardia and hypotension induced by drugs such as suxamethonium, halothane or propofol. Antimuscarinic drugs are competitive inhibitors of the actions of acetylcholine at the muscarinic receptors of autonomic effector sites innervated by parasympathetic nerves.

Pre-anesthetic (Adults):

• 0.2-0.4 mg IV or IM before induction of anesthesia
• or 0.004-0.005 mg/kg (max 0.4 mg)

Pre-anesthetic (Children 1 month-12 years):

• 0.004-0.008 mg/kg (max 0.2 mg) IV or IM

Intraoperative (Adults):

• 0.2-0.4 mg (or 0.004-0.005 mg/kg, max 0.4 mg) IV

Reversal of Neuromuscular Blockade:

• Adults: 0.2 mg IV per 1 mg neostigmine
• Children: 0.01 mg/kg IV with 0.05 mg/kg neostigmine

* Use as directed by the registered physician

Common Side Effects:

• Dry mouth
• Constipation
• Tachycardia
• Palpitations
• Urinary retention
• Blurred vision
• Photophobia
• Flushing
• Nausea
• Dizziness

Use in Pregnancy: Generally considered safe during pregnancy. Animal studies have shown low or no adverse effects.

Precautions:

• Use with caution in Down's syndrome, children and elderly
• Caution in gastro-esophageal reflux disease, diarrhea, ulcerative colitis
• Caution in acute myocardial infarction, hypertension, hyperthyroidism
• Avoid repeated or large doses in uremia patients
• Caution in myasthenia gravis

Overdose: Glycopyrronium bromide is a quaternary ammonium agent - symptoms are peripheral. Neostigmine methylsulphate IV (0.25 mg increments in adults, repeated every 5-10 minutes, max 2.5 mg) may be given.

Storage: Keep below 25°C, away from light and moisture. Keep out of reach of children.