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글리코피롤레이트

Glycopyrrolate

Glycopyrronium bromide

항콜린제 (항무스카린제)IVIMSCPO개고양이소형 포유류페렛파충류말

다른 이름: Robinul-V · Robinul Forte · glycopyrronium bromide · AHR-504 · Acpan · AmTech · Gastrodyn · Glycostigmin

VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료

감사 완료 v13 용량 근거

검토된 비계산 근거
검토된 비계산 근거 (1)

근거 표시 전용 — 자동 계산 불가

Premedication (extra-label)

Premedication (extra-label): 0.01 – 0.02 mg/kg IM, SC, or IV

IMIVSC
반드시 함께 고려할 임상 맥락 (1)
  • Glycopyrrolate tablets should be stored in tight containers and both the injection and tablets should be stored at room temperature (15°C -30°C [59°F-86°F]).
고위험인증된 수의사 확인 필요reviewed_narrative프로토콜 2023감사 dose-audit-plumb-v13

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개요

글리코피롤레이트는 합성 4급 암모늄 항무스카린제로, 주로 마취 전 투약, 서맥 치료 및 타액 분비 감소를 위해 사용됩니다. 아트로핀과 달리 혈액뇌장벽을 잘 통과하지 않아 중추신경계 부작용이 적습니다.

작용 기전

Glycopyrrolate acts as a competitive antagonist of acetylcholine at postganglionic muscarinic receptors (M1, M2, M3).

Acetylcholine → Blocked at Muscarinic Receptors → Decreased parasympathetic tone.

This blockade leads to:

  • ​Heart:​ Vagolytic effect → Increased heart rate (tachycardia).
  • ​Secretions:​ Antisialagogue effect → Profound reduction in salivary, tracheobronchial, and pharyngeal secretions.
  • ​GI/Urinary:​ Decreased smooth muscle motility and tone.
  • ​Eye:​ Mydriasis (pupil dilation) and cycloplegia.

안전성·주의사항

금기사항

  • Narrow angle glaucoma
  • Tachycardias
  • Gastrointestinal ileus
  • Urinary obstruction
  • Hypersensitivity to the drug
  • Pregnancy (per some manufacturer labels)

부작용

  • Dry secretions (xerostomia)
  • Initial bradycardia followed by tachycardia
  • Decreased gastrointestinal motility (risk of ileus)
  • Decreased urinary tract motility
  • Mydriasis and cycloplegia

주의

Use with extreme caution in patients with known or suspected GI infections, as decreased GI motility can prolong retention of toxins or causative agents. Use with extreme caution in patients with autonomic neuropathy.

Use cautiously in patients with hepatic or renal disease, geriatric or pediatric patients, hyperthyroidism, hypertension, congestive heart failure (CHF), tachyarrhythmias, prostatic hypertrophy, or esophageal reflux. Can produce sinus tachycardia and predispose hypotensive patients to cardiac arrhythmias (including ventricular fibrillation).

약물 상호작용

Amantadine

May enhance the activity or toxicity of glycopyrrolate.

Antihistamines (e.g., diphenhydramine)

May enhance anticholinergic activity or toxicity.

Meperidine

May enhance anticholinergic activity or toxicity.

Phenothiazines

May enhance anticholinergic activity or toxicity.

Tricyclic Antidepressants (e.g., amitriptyline, clomipramine)

May enhance anticholinergic activity or toxicity.

Amitraz

May aggravate signs seen with amitraz toxicity, leading to hypertension and further inhibition of peristalsis.

Antacids

May decrease PO absorption; give oral glycopyrrolate at least 1 hour prior to oral antacids.

Corticosteroids (long-term use)

May increase intraocular pressure when used concurrently.

Digoxin (slow-dissolving)

May increase serum digoxin levels; use regular digoxin tablets or oral liquid.

Ketoconazole

Increased gastric pH may decrease GI absorption; administer 2 hours after ketoconazole.

Metoclopramide

Glycopyrrolate may antagonize the prokinetic actions of metoclopramide.

모니터링

  • Heart rate and rhythm
  • Respiratory rate and effort
  • Gastrointestinal motility (auscultation for bowel sounds)
  • Salivary and respiratory secretions

약동학

흡수

Not completely absorbed after oral administration. In dogs, IV onset of action is generally within 1 minute. After IM or SC administration, peak effects occur approximately 30-45 minutes post-injection.

분포

Completely ionized quaternary ammonium compound; poor lipid solubility. Does not readily penetrate into the CNS or eye. Crosses the placenta only marginally.

대사

Only a small amount is metabolized.

배설

Eliminated rapidly from the serum after IV administration (virtually no drug remains 30 minutes to 3 hours after dosing). Majority is eliminated unchanged in the feces and urine.

과다투여

In dogs, the LD50 is reported to be 25 mg/kg IV. In cats, the LD50 after IM injection is 283 mg/kg. Because of its quaternary structure, minimal CNS effects would be expected after an overdose compared to atropine. Overdose may present with severe anticholinergic signs (extreme tachycardia, mydriasis, dry mucous membranes, ileus). Treatment is generally supportive.

제품

제형

  • Injection
  • Tablets

동물용의약품

  • Glycopyrrolate for Injection: 0.2 mg/mL in 20 mL vials; Robinul-V (Pfizer), generic

인용의약품

  • Glycopyrrolate Tablets: 1 mg & 2 mg; Robinul & Robinul Forte (Horizon); generic
  • Glycopyrrolate Injection: 0.2 mg/mL in 1 mL, 2 mL, 5 mL, & 20 mL vials; Robinul (Robins); generic

규제 현황

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보관·안정성

Tablets should be stored in tight containers. Both injection and tablets should be stored at room temperature (15-30°C). Stable under ordinary conditions of light and temperature. Most stable in solution at an acidic pH; undergoes ester hydrolysis at pH above 6.

보호자 정보

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