글리코피롤레이트
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.
동물 종별 용량
- As an adjunct to anesthesia · 0.011 mg/kg · IM · For maximum effect give 15 minutes prior to anesthetic administration
- For bradyarrhythmias · 0.005-0.01 mg/kg IV or IM, 0.01-0.02 mg/kg SC · IV, IM, SC
- Associated with anesthesia · 0.005-0.01 mg/kg · IV
- As a premed · 0.01 mg/kg · SC or IM
- As a premed · 0.01-0.02 mg/kg · IM or IV
- For treatment of bradyarrhythmias · 0.005-0.01 mg/kg (5-10 micrograms/kg) · IV · Note: ARCI UCGFS Class 3 Drug
- As a bronchodilator · 2-3 mg · IM · two to three times daily · Dose for a 450 kg animal
- To control muscarinic adverse effects associated with imidocarb therapy · 0.0025 mg/kg · IV
- For prevention of bradycardia and to decrease airway and salivary secretions (Rabbits) · 0.01-0.1 mg/kg IM, SC; 0.01 mg/kg IV · IM, SC, IV
- As adjunct to anesthesia (Rabbits) · 0.01-0.02 mg/kg · SC · as needed
- As a preanesthetic (Rodents) · 0.01-0.02 mg/kg · SC or IM
- As a preanesthetic (Rabbits) · 0.01-0.1 mg/kg · IM or SC
- As part of an injectable anesthesia protocol in rabbits · 0.01 mg/kg · IM · Given with acepromazine (0.2 mg/kg) and oxymorphone (0.1 mg/kg)
- As an adjunct to anesthesia · 0.011 mg/kg · IV, IM, or SC
- As an adjunct to anesthesia · 0.01-0.02 mg/kg · SC or IM
- For adjunctive therapy of bradyarrhythmias · 0.011 mg/kg · IV or IM
- Associated with anesthesia · 0.005-0.01 mg/kg · IV
- For bradyarrhythmias (sinus bradycardia, high-grade 2nd-degree and 3rd-degree AV block) produced by increased vagal tone · 0.05-0.1 mg/kg · IV
- To reduce hypersialism · 0.01 mg/kg · SC · as needed
- For bradycardia (prolonged or profound) associated with anesthesia · 0.01 mg/kg · IM, IV or IC (intracoelemic)
용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.
투여 경로
금기
- Narrow angle glaucoma
- Tachycardias
- Gastrointestinal ileus
- Urinary obstruction
- Hypersensitivity to the drug
- Pregnancy (per some manufacturer labels)
이상반응
- Dry secretions (xerostomia)
- Initial bradycardia followed by tachycardia
- Decreased gastrointestinal motility (risk of ileus)
- Decreased urinary tract motility
- Mydriasis and cycloplegia
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
과용량
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.
VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.