格隆溴銨 / 糖吡咯酯
**格隆溴銨**（又稱**糖吡咯酯**）是一種強效的抗膽鹼藥物及抗涎劑。在獸醫麻醉中主要用於減少口腔與支氣管分泌物、抑制迷走神經傳出活性，以及處理因施打強效鴉片類藥物所引起的心跳過緩。它也常與長效抗膽鹼酯酶藥物（如新斯狄明 neostigmine）併用，以拮抗神經肌肉阻斷劑的作用。 > **臨床警告：** 目前已不建議將格隆溴銨作為麻醉前給藥的常規程序。因為它會減少分泌物中的水分，導致呼吸道分泌物變得更加黏稠且難以清除。
作用機制: Competitively blocks the action of **acetylcholine** at **muscarinic receptors** at the terminal ends of the parasympathetic nervous system → reverses parasympathetic effects (e.g., increases heart rate, reduces salivation). **Clinical Pearl:** Because of its quaternary ammonium structure, glycopyrronium cannot cross the blood-brain barrier. Therefore, it is devoid of central nervous system effects and does not cause central mydriasis, unlike atropine. It also has a longer duration of action compared to atropine.
給藥途徑
禁忌症
- Concurrent use with alpha-2 adrenergic agonists is not recommended
不良反應
- Tachycardia
- Ventricular arrhythmias
- Thickened, sticky airway secretions
- Paradoxical bradycardia (at very low IV doses)
藥物相互作用
- Barbiturates (alkaline drugs) · In vitro incompatibility; a precipitate may form if mixed together · major
- Sympathomimetics · Antimuscarinics may enhance the actions of sympathomimetics · moderate
- Thiazide diuretics · Antimuscarinics may enhance the actions of thiazide diuretics · moderate
- Antihistamines · May enhance the anticholinergic activity of glycopyrronium · moderate
- Pethidine · May enhance the anticholinergic activity of glycopyrronium · moderate
- Benzodiazepines · May enhance the anticholinergic activity of glycopyrronium · moderate
- Phenothiazines · May enhance the anticholinergic activity of glycopyrronium · moderate
- Alpha-2 adrenergic agonists · Combining glycopyrronium and alpha-2 adrenergic agonists is not recommended due to conflicting cardiovascular effects · major
監測
- Heart rate and rhythm (ECG)
- Respiratory rate and airway patency
過量
Tachycardias following an overdose of glycopyrronium are usually transient and do not require management. If severe ventricular arrhythmias occur, they may be treated with **lidocaine**.
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。