Glycopyrrolate (Robinul)

Indications

Cholinergic Intoxication (see Cholinergic Intoxication, [[Cholinergic Intoxication]])

  • Formulation: SQ

Cigua Toxin Poisoning (see Cigua Toxin Poisoning, [[Cigua Toxin Poisoning]])

  • Formulation: SQ
  • Toxin: scaritoxin (which is a ciguatera-associated toxin) -> increases permeability of sodium channels, resulting in norepinephrine and acetylcholine release

“Death Rattle” in Dying Patient

  • Formulation: SQ
  • Clinical Efficacy
    • Systematic Review of Interventions for Noisy Breathing in the Dying Patient (Cochrane Database Syst Rev, 2008) [MEDLINE]
      • No Intervention (Pharmacologic or Non-Pharmacologic) Had Any Efficacy in Treating Death Rattle
    • Systematic Review of Antimuscarinic Drugs in zTreating Death Rattle (J Pain Symptom Manage. 2014) [MEDLINE]
      • Antimuscarinic Drugs (Glycopyrrolate, Scopolamine) Had No Efficacy in Treating Death Rattle (see Glycopyrrolate, [[Glycopyrrolate]])

Scorpion Envenomation (see Scorpion Sting, [[Scorpion Sting]])

  • Formulation: SQ
  • Associated Scorpion Species
    • Centuroides Exilicauda (Sculpuratus)
    • Centuroides Suffusus

Toxic Mushrooms (see Toxic Mushrooms, [[Toxic Mushrooms]])

  • Formulation: SQ
  • Associated Mushrooms
    • Boletus Calopus
    • Clitocybe Dealbata
    • Clitocybe Illudens
    • Inocybe Fastigiata
  • Toxin: muscarine -> acts at muscarinic receptors in autonomic nervous system

Other

  • Formulation: SQ
  • Carbamate Intoxication (see Carbamates, [[Carbamates]])
  • Organophosphate Intoxication (see Organophosphates, [[Organophosphates]])

Pharmacology

  • xxx

Metabolism

  • xxxx

Administration

  • Glycopyrrolate (Robinul)
    • SQ
  • Glycopyrrolate + Indacaterol (Ultibro Breezhaler) (see Glycopyrrolate + Indacaterol, [[Glycopyrrolate + Indacaterol]])
    • INH

Dose Adjustment

  • Hepatic:
  • Renal:

Adverse Effects

Other Adverse Effects

  • xxx
  • xxx
  • xxx

References

  • Interventions for noisy breathing in patients near death. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD005177 [MEDLINE]
  • Prevalence, impact, and treatment of death rattle: a systemic review. J Pain Symptom Manage. 2014;47:105–122 [MEDLINE]