Glycopyrrolate

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Glycopyrrolate
Systematic (IUPAC) name
3-(2-cyclopentyl-2-hydroxy-2-phenylacetoxy)-1,1-dimethylpyrrolidinium
Clinical data
AHFS/Drugs.commonograph
MedlinePlusa602014
Pregnancy cat.B
Legal status ?
Routesoral, IV
Pharmacokinetic data
Half-life0.6–1.2 hours
Excretion85% renal, unknown amount in the bile
Identifiers
CAS number596-51-0 YesY
ATC codeA03AB02
PubChemCID 3494
DrugBankDB00986
ChemSpider11201 YesY
UNIIV92SO9WP2I YesY
KEGGD00540 YesY
ChEMBLCHEMBL1201335 N
Chemical data
FormulaC19H28NO3+
Mol. mass318.431 g/mol
 N (what is this?)  (verify)
 
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Glycopyrrolate
Systematic (IUPAC) name
3-(2-cyclopentyl-2-hydroxy-2-phenylacetoxy)-1,1-dimethylpyrrolidinium
Clinical data
AHFS/Drugs.commonograph
MedlinePlusa602014
Pregnancy cat.B
Legal status ?
Routesoral, IV
Pharmacokinetic data
Half-life0.6–1.2 hours
Excretion85% renal, unknown amount in the bile
Identifiers
CAS number596-51-0 YesY
ATC codeA03AB02
PubChemCID 3494
DrugBankDB00986
ChemSpider11201 YesY
UNIIV92SO9WP2I YesY
KEGGD00540 YesY
ChEMBLCHEMBL1201335 N
Chemical data
FormulaC19H28NO3+
Mol. mass318.431 g/mol
 N (what is this?)  (verify)

Glycopyrrolate 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.

With counterion, it is known as glycopyrronium bromide.[1]

Contents

Pharmacology

Glycopyrrolate blocks muscarinic receptors,[2] thus inhibiting cholinergic transmission.

Medical uses

In anesthesia, glycopyrrolate 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).[3][4][5]

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[6][7] and COPD[8] has been described.

It has been used topically and orally to treat hyperhidrosis.[9][10]

Side effects

Since glycopyrrolate reduces the body's sweating ability, it can even cause fever 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 visions, an effect exacerbated by the consumption of alcohol.

References

  1. ^ 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. http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0007-0963&date=2007&volume=157&issue=1&spage=118. 
  2. ^ 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. //www.ncbi.nlm.nih.gov/pmc/articles/PMC1566042/. 
  3. ^ 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. PMID 11115305. http://archpedi.ama-assn.org/cgi/pmidlookup?view=long&pmid=11115305. 
  4. ^ Tscheng DZ (November 2002). "Sialorrhea - therapeutic drug options". Ann Pharmacother 36 (11): 1785–90. doi:10.1345/aph.1C019. PMID 12398577. http://www.theannals.com/cgi/pmidlookup?view=long&pmid=12398577. 
  5. ^ 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. http://linkinghub.elsevier.com/retrieve/pii/S0885-3924(99)00080-9. 
  6. ^ 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. http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=16236844. 
  7. ^ 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. http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=2225951. 
  8. ^ 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. http://erj.ersjournals.com/cgi/pmidlookup?view=long&pmid=8834341. 
  9. ^ Kim WO, Kil HK, Yoon DM, Cho MJ (August 2003). "Treatment of compensatory gustatory hyperhidrosis with topical glycopyrrolate" ([dead link]). Yonsei Med. J. 44 (4): 579–82. PMID 12950111. http://www.eymj.org/abstracts/viewArticle.asp?year=2003&page=579. 
  10. ^ 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. http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0007-0963&date=2008&volume=158&issue=5&spage=1094.