格隆溴銨 / 糖吡咯酯
Glycopyrronium (Glycopyrrolate)
Glycopyrronium bromide
別名: Robinul · Glycopyrrolate · Glycopyrronium bromide
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
各物種劑量
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概覽
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.
安全性與警告
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)
注意事項
- Paradoxical Bradycardia: Administration of very low doses of glycopyrronium IV can cause exacerbation of bradyarrhythmias due to a vagal stimulatory effect. Giving another dose IV will usually cause an increase in heart rate.
- Airway Secretions: Decreases the water content of oral and bronchial secretions, making them more sticky.
- Opioid Bradycardia: It is better to monitor heart rate and give glycopyrronium to manage a low heart rate only if necessary, rather than as a routine premedication.
藥物相互作用
In vitro incompatibility; a precipitate may form if mixed together
Antimuscarinics may enhance the actions of sympathomimetics
Antimuscarinics may enhance the actions of thiazide diuretics
May enhance the anticholinergic activity of glycopyrronium
May enhance the anticholinergic activity of glycopyrronium
May enhance the anticholinergic activity of glycopyrronium
May enhance the anticholinergic activity of glycopyrronium
Combining glycopyrronium and alpha-2 adrenergic agonists is not recommended due to conflicting cardiovascular effects
監測
- Heart rate and rhythm (ECG)
- Respiratory rate and airway patency
藥物動力學
吸收
Rapidly absorbed following IM or SC administration.
分佈
Does not cross the blood-brain barrier or placenta significantly due to its quaternary ammonium structure.
代謝
Undergoes minimal hepatic metabolism.
排除
Excreted primarily unchanged in the urine and feces.
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.
可用產品
劑型
- Injectable: 200 μg/ml solution
獸醫用
- Robinul 200 μg/ml solution for injection
人用標示
- Robinul 200 μg/ml solution for injection
各地核准狀態
POM (Prescription Only Medicine)
POM-V
暫無法規資料: 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Normal precautions should be observed. Store at room temperature and protect from light.
飼主須知
本藥物通常由獸醫師在診所或醫院的麻醉或手術期間施打。主要用於在麻醉期間安全地控制寵物的心跳速率，並減少過多的唾液與呼吸道分泌物。
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