Glycopyrronium bromide
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| Clinical data | |
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| Pregnancy category |
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| ATC code | A03AB02 (WHO) R03BB06 (WHO) |
| Legal status | |
| Legal status |
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| Identifiers | |
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| CAS Number |
51186-83-5  |
| PubChem (CID) | 11693 |
| ChemSpider | 11201 |
| UNII |
V92SO9WP2I |
| ECHA InfoCard | 100.008.990 |
| Chemical and physical data | |
| Formula | C19H28BrNO3 |
| Molar mass | 398.335 g/mol |
| 3D model (Jmol) | Interactive image |
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| Clinical data | |
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| AHFS/Drugs.com | Monograph |
| MedlinePlus | a602014 |
| Pregnancy category |
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| Routes of administration | oral, IV |
| ATC code | A03AB02 (WHO) R03BB06 (WHO) |
| Legal status | |
| Legal status |
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| Pharmacokinetic data | |
| Biological half-life | 0.6–1.2 hours |
| Excretion | 85% renal, unknown amount in the bile |
| Identifiers | |
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| CAS Number |
596-51-0 |
| PubChem (CID) | 3494 |
| IUPHAR/BPS | 7459 |
| DrugBank |
DB00986 |
| ChemSpider | 3374 |
| UNII |
V92SO9WP2I |
| KEGG |
D00540 |
| ChEMBL |
CHEMBL1201335  |
| ECHA InfoCard | 100.008.990 |
| Chemical and physical data | |
| Formula | C19H28NO3+ |
| Molar mass | 318.431 g/mol |
| 3D model (Jmol) | Interactive image |
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| (what is this?) (verify) | |
Glycopyrronium bromide is a medication of the muscarinic anticholinergic group. It does not cross the blood–brain barrier and consequently has no to few central effects. A synthetic quaternary amine, it is available in oral and intravenous (i.v.) forms. It was developed by Sosei and licensed to Novartis in 2005. The cation, which is the active moiety, is also known as Glycopyrronium.[1]
Medical uses
In anesthesia, glycopyrronium injection can be used as a preoperative medication in order to reduce salivary, tracheobronchial, and pharyngeal secretions, as well as decreasing the acidity of gastric secretion. It is also used in conjunction with neostigmine, a neuromuscular blocking reversal agent, to prevent neostigmine's muscarinic effects such as bradycardia.
It is also used to reduce excessive saliva (sialorrhea).[2][3][4]
It decreases acid secretion in the stomach and so may be used for treating stomach ulcers, in combination with other medications.
Use in treating asthma[5][6] and COPD[7] has been described.
It has been used topically and orally to treat hyperhidrosis, in particular, gustatory hyperhidrosis.[8][9]
It is used to treat Ménière's disease.[10]
Side effects
Since glycopyrronium reduces the body's sweating ability, it can even cause hyperthermia and heat stroke in hot environments. Dry mouth, difficulty urinating, headaches, diarrhea and constipation are also observed side effects of the medication. The medication also induces drowsiness or blurred vision, an effect exacerbated by the consumption of alcohol.
Pharmacology
Glycopyrronium blocks muscarinic receptors,[11] thus inhibiting cholinergic transmission.
Pharmacokinetics
Glycopyrronium bromide affects the gastrointestinal tracts, liver and kidney but has a very limited effect on the brain and the central nervous system. In horse studies, after a single intravenous infusion, the tendency of glycopyrronium followed a tri-exponential equation, followed by rapid disappearance from the blood followed by a prolonged terminal phase. Excretion was mainly in urine and in the form of an unchanged drug. Glycopyrronium has a relatively slow diffusion rate, and in a standard comparison to atropine, is more resistant to penetration through the blood-brain barrier and placenta.[12]
References
- ↑ Bajaj V, Langtry JA (July 2007). "Use of oral glycopyrronium bromide in hyperhidrosis". Br. J. Dermatol. 157 (1): 118–21. doi:10.1111/j.1365-2133.2007.07884.x. PMID 17459043.
- ↑ Mier RJ, Bachrach SJ, Lakin RC, Barker T, Childs J, Moran M (December 2000). "Treatment of sialorrhea with glycopyrrolate: A double-blind, dose-ranging study". Arch Pediatr Adolesc Med. 154 (12): 1214–8. doi:10.1001/archpedi.154.12.1214. PMID 11115305.
- ↑ Tscheng DZ (November 2002). "Sialorrhea - therapeutic drug options". Ann Pharmacother. 36 (11): 1785–90. doi:10.1345/aph.1C019. PMID 12398577.
- ↑ Olsen AK, Sjøgren P (October 1999). "Oral glycopyrrolate alleviates drooling in a patient with tongue cancer". J Pain Symptom Manage. 18 (4): 300–2. doi:10.1016/S0885-3924(99)00080-9. PMID 10534970.
- ↑ Hansel TT, Neighbour H, Erin EM, et al. (October 2005). "Glycopyrrolate causes prolonged bronchoprotection and bronchodilatation in patients with asthma". Chest. 128 (4): 1974–9. doi:10.1378/chest.128.4.1974. PMID 16236844.
- ↑ Gilman MJ, Meyer L, Carter J, Slovis C (November 1990). "Comparison of aerosolized glycopyrrolate and metaproterenol in acute asthma". Chest. 98 (5): 1095–8. doi:10.1378/chest.98.5.1095. PMID 2225951.
- ↑ Tzelepis G, Komanapolli S, Tyler D, Vega D, Fulambarker A (January 1996). "Comparison of nebulized glycopyrrolate and metaproterenol in chronic obstructive pulmonary disease". Eur. Respir. J. 9 (1): 100–3. doi:10.1183/09031936.96.09010100. PMID 8834341.
- ↑ Kim WO, Kil HK, Yoon DM, Cho MJ (August 2003). "Treatment of compensatory gustatory hyperhidrosis with topical glycopyrrolate". Yonsei Med. J. 44 (4): 579–82. doi:10.3349/ymj.2003.44.4.579. PMID 12950111.
- ↑ Kim WO, Kil HK, Yoon KB, Yoon DM (May 2008). "Topical glycopyrrolate for patients with facial hyperhidrosis". Br. J. Dermatol. 158 (5): 1094–7. doi:10.1111/j.1365-2133.2008.08476.x. PMID 18294315.
- ↑ Maria, Sammartano Azia; Claudia, Cassandro; Pamela, Giordano; Andrea, Canale; Roberto, Albera (1 December 2012). "Medical therapy in Ménière's disease". Audiological Medicine. 10 (4): 171–177. doi:10.3109/1651386X.2012.718413 – via Taylor and Francis+NEJM.
- ↑ Haddad EB, Patel H, Keeling JE, Yacoub MH, Barnes PJ, Belvisi MG (May 1999). "Pharmacological characterization of the muscarinic receptor antagonist, glycopyrrolate, in human and guinea-pig airways". Br. J. Pharmacol. 127 (2): 413–20. doi:10.1038/sj.bjp.0702573. PMC 1566042
. PMID 10385241. - ↑ Rumpler, M.J.; Colahan, P.; Sams, R.A. (2014). "The pharmacokinetics of glycopyrrolate in Standardbred horses". J. Vet Pharmacol Ther. 3 (37): 260–8. doi:10.1111/jvp.12085. PMID 24325462.