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Glycopyrrolate

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https://www.readbyqxmd.com/read/28794837/use-of-sugammadex-in-lung-cancer-patients-undergoing-video-assisted-thoracoscopic-lobectomy
#1
Hyun Chul Cho, Jong Hwan Lee, Seung Cheol Lee, Sang Yoong Park, Jong Cheol Rim, So Ron Choi
BACKGROUND: This study aimed to retrospectively evaluate the use of sugammadex in patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy. METHODS: Data were obtained from medical record review of patients who underwent VATS lobectomy from January 2013 to November 2014. Fifty patients were divided into two groups: the sugammadex group (group S, n = 19) was administered sugammadex 2 mg/kg, while the pyridostigmine group (group P, n = 31) received pyridostigmine 20 mg with glycopyrrolate 0...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28757318/new-treatment-option-for-copd-two-long-acting-bronchodilators-in-a-single-metered-dose-inhaler
#2
REVIEW
Timothy H Self, Samantha Ellingson
Combination long-acting inhaled bronchodilators are central to the management of moderate to very severe chronic obstructive pulmonary disease (COPD) patients. Glycopyrrolate is a long-acting muscarinic antagonist (LAMA), and formoterol fumarate is a long-acting beta2 agonist (LABA). In randomized controlled trials, this LAMA/LABA combination in a metered dose inhaler (MDI) was shown to be effective in improving pulmonary function and quality of life. Clinicians now have the availability of three delivery systems for LAMA/LABA therapy, including MDI, dry-powder inhaler, and Soft Mist inhaler...
July 27, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28732826/corrigendum-to-a-multicenter-randomized-double-blind-dose-ranging-study-of-glycopyrrolate-formoterol-fumarate-fixed-dose-combination-metered-dose-inhaler-compared-to-the-monocomponents-and-open-label-tiotropium-dry-powder-inhaler-in-patients-with-moderate-to
#3
Donald P Tashkin, Fernando J Martinez, Roberto Rodriguez-Roisin, Charles Fogarty, Mark Gotfried, Michael Denenberg, Gregory Gottschlich, James F Donohue, Chad Orevillo, Patrick Darken, Earl St Rose, Shannon Strom, Tracy Fischer, Michael Golden, Colin Reisner
No abstract text is available yet for this article.
August 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28720336/baseline-symptom-score-impact-on-benefits-of-glycopyrrolate-formoterol-metered-dose-inhaler-in-copd
#4
Fernando J Martinez, Leonardo M Fabbri, Gary T Ferguson, Chad Orevillo, Patrick Darken, Ubaldo J Martin, Colin Reisner
BACKGROUND: The clinical severity of COPD is currently categorized by symptom burden and exacerbation risk. Previous 24-week phase III trials (NCT01854645 and NCT01854658) that demonstrated better improvement of lung function with glycopyrrolate/formoterol fumarate (GFF) metered dose inhaler (MDI) (an MDI fixed-dose of GFF 18/9.6 μg) over individual monocomponent MDIs included a cross-section of patients with moderate to very severe airflow limitation and a broad range of COPD symptoms...
July 16, 2017: Chest
https://www.readbyqxmd.com/read/28713660/a-cross-sectional-pharmacoepidemiological-study-of-the-utilization-pattern-of-pre-anesthetic-medications-in-major-surgical-procedures-in-a-tertiary-care-hospital
#5
Madhuri Kulkarni, Anant Patil
OBJECTIVE : A study of the utilization pattern of pre-anesthetic medications in major surgical procedures. MATERIAL AND METHODS : A cross-sectional, pharmacoepidemiological study was conducted among patients undergoing surgical procedures in routine or emergency conditions under general anesthesia. The utilization of pre-anesthetic medicines in all patients was reported. RESULTS: A total of 110 patients (mean age - 42.36 years; 57.27% males) were enrolled...
June 13, 2017: Curēus
https://www.readbyqxmd.com/read/28704246/the-effect-of-glycopyrrolate-on-the-incidence-of-hypotension-and-vasopressor-requirement-during-spinal-anesthesia-for-cesarean-delivery-a-meta-analysis
#6
Selina D Patel, Ashraf S Habib, Sioned Phillips, Brendan Carvalho, Pervez Sultan
BACKGROUND: The objective of this meta-analysis was to determine the efficacy of glycopyrrolate at reducing spinal hypotension during cesarean delivery. METHODS: A literature search was performed to identify randomized controlled trials investigating the effect of glycopyrrolate on spinal-induced hypotension during cesarean delivery. Primary outcomes were intraoperative hypotension and vasopressor requirement (phenylephrine equivalents). Secondary outcomes included heart rate (HR), nausea and vomiting, dry mouth, and Apgar scores...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28650904/pediatric-procedural-sedation-using-the-combination-of-ketamine-and-propofol-outside-of-the-emergency-department-a-report-from-the-pediatric-sedation-research-consortium
#7
Jocelyn R Grunwell, Curtis Travers, Anne G Stormorken, Patricia D Scherrer, Corrie E Chumpitazi, Jana A Stockwell, Mark G Roback, Joseph Cravero, Pradip P Kamat
OBJECTIVES: Outcomes associated with a sedative regimen comprised ketamine + propofol for pediatric procedural sedation outside of both the pediatric emergency department and operating room are underreported. We used the Pediatric Sedation Research Consortium database to describe a multicenter experience with ketamine + propofol by pediatric sedation providers. DESIGN: Prospective observational study of children receiving IV ketamine + propofol for procedural sedation outside of the operating room and emergency department using data abstracted from the Pediatric Sedation Research Consortium during 2007-2015...
August 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28637064/safety-and-efficacy-of-glycopyrrolate-as-a-premedication-for-endoscopic-submucosal-dissection-a-randomized-double-blind-placebo-controlled-study
#8
Eui Joo Kim, Min Young Um, Kyoung Oh Kim, Jung Ho Kim, Su Young Kim, Dong Kyun Park, Kwang An Kwon, Jun Won Chung, Yoon Jae Kim
Background and study aims Anticholinergic premedication has not been validated for endoscopic submucosal dissection (ESD). In this randomized, double-blind, placebo-controlled trial, we investigated the efficacy and safety of glycopyrrolate as a premedication for ESD. Methods A total of 196 patients undergoing ESD at a single tertiary medical center between December 2014 and February 2016 were randomly allocated to receive one of the following two premedications: glycopyrrolate (0.004 mg/kg intramuscularly [IM]) or placebo (2...
June 21, 2017: Endoscopy
https://www.readbyqxmd.com/read/28599943/correction-to-results-table-and-figure-in-efficacy-and-safety-of-glycopyrrolate-formoterol-metered-dose-inhaler-formulated-using-co-suspension-delivery-technology-in-patients-with-copd
#9
https://www.readbyqxmd.com/read/28596292/the-pde4-inhibitor-chf-6001-and-lamas-inhibit-bronchoconstriction-induced-remodelling-in-lung-slices
#10
Loes Em Kistemaker, Tjitske A Oenema, Hoeke A Baarsma, I Sophie T Bos, Martina Schmidt, Fabrizio Facchinetti, Maurizio Civelli, Gino Villetti, Reinoud Gosens
Background Combination therapy of PDE4 inhibitors and anticholinergics induces bronchoprotection in COPD. Mechanical forces that arise during bronchoconstriction may contribute to airway remodelling. Therefore, we investigated the impact of PDE4 inhibitors and anticholinergics on bronchoconstriction-induced remodelling. Because of the different mechanism of action of PDE4 inhibitors and anticholinergics, we hypothesized functional interactions of these two drug classes. Methods Guinea pig precision cut lung slices were pre-incubated with the PDE4-inhibitors CHF-6001 or roflumilast and/or the anticholinergics tiotropium or glycopyorrolate, followed by stimulation with methacholine (10 μM) or TGF -β1 (2 ng/mL) for 48 hours...
June 8, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28493510/comparison-of-reversal-with-neostigmine-of-low-dose-rocuronium-vs-reversal-with-sugammadex-of-high-dose-rocuronium-for-a-short-procedure
#11
E S Choi, A Y Oh, B W Koo, J W Hwang, J W Han, K S Seo, S H Ahn, W J Jeong
Some short procedures require deep neuromuscular blockade, which needs to be reversed at the end of the procedure. Forty-four patients undergoing elective laryngeal micro-surgery were randomly allocated into two groups: rocuronium 0.45 mg.kg(-1) with neostigmine (50 μg.kg(-1) with glycopyrrolate 10 μg.kg(-1) ) reversal (moderate block group) vs. rocuronium 0.90 mg.kg(-1) with sugammadex (4 mg.kg(-1) ) reversal (deep block group). The primary outcome was the intubating conditions during laryngoscopy secondary outcomes included recovery of neuromuscular block; conditions for tracheal intubation; satisfaction score as determined by the surgeon; onset of neuromuscular block; and postoperative sore throat...
May 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28479415/off-label-medication-use-in-the-inpatient-palliative-care-unit
#12
Jung Hye Kwon, Min Ji Kim, Sebastian Bruera, Minjeong Park, Eduardo Bruera, David Hui
CONTEXT: Although off-label medications are frequently prescribed in palliative care, there are no published studies examining their use in the U.S. OBJECTIVES: We examined the frequency of off-label medication use in cancer patients admitted to an acute palliative care unit (APCU). METHODS: This prospective observational study enrolled consecutive patients with advanced cancer admitted to the APCU of a tertiary care cancer center. We collected data on all prescription events, including indications for use, from admission to discharge...
July 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28443352/gff-mdi-for-the-improvement-of-lung-function-in-copd-a-look-at-the-pinnacle-1-and-pinnacle-2-data-and-beyond
#13
Klaus F Rabe
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death globally and incidence rates are continuing to rise. Long-acting bronchodilators are the foundation on which current pharmacological approaches to COPD management are built, with long-acting muscarinic antagonists (LAMAs) and long-acting β2-agonists (LABAs) recommended across the spectrum of the disease continuum. Combining LAMAs and LABAs provides additional lung function improvements and relief of patient symptoms compared with either therapy alone...
July 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28427541/long-term-safety-and-efficacy-of-glycopyrrolate-formoterol-metered-dose-inhaler-using-novel-co-suspension%C3%A2-delivery-technology-in-patients-with-chronic-obstructive-pulmonary-disease
#14
Nicola A Hanania, Donald P Tashkin, Edward M Kerwin, James F Donohue, Michael Denenberg, Denis E O'Donnell, Dean Quinn, Shahid Siddiqui, Chad Orevillo, Andrea Maes, Colin Reisner
BACKGROUND: The long-term safety and efficacy of a novel Co-Suspension™ Delivery Technology glycopyrrolate (GP)/formoterol fumarate (FF) 18/9.6 μg fixed-dose combination metered dose inhaler (GFF MDI) were investigated in a 28-week safety extension study (PINNACLE-3, NCT01970878) of two randomized controlled Phase III trials (PINNACLE-1 and -2; NCT01854645 and NCT01854658) in subjects with moderate-to-very severe chronic obstructive pulmonary disease (COPD). METHODS: Subjects completing 24 weeks' treatment with GFF MDI, GP MDI, FF MDI (all twice-daily) or open-label tiotropium 18 μg (once-daily) in PINNACLE-1 or -2 were randomly selected to continue treatment for 28 weeks...
May 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28412263/oculocardiac-reflex-in-an-orbital-fracture-without-entrapment
#15
Timothy C Woernley, Thomas L Wright, Duc N Lam, Jonathon S Jundt
Large orbital fractures in older patients are infrequently associated with an exaggerated oculocardiac reflex. This report describes the case of a patient in his 40s with a large right orbital floor and medial wall fracture without radiographic evidence of extraocular muscle compression or entrapment who developed severe nausea and bradycardia with movement of his affected eye. The patient exhibited bradycardia to 17 beats per minute during the initial examination and was taken urgently to the operating room for reconstruction of the right orbital floor and medial wall...
March 21, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28399799/half-dose-sugammadex-combined-with-neostigmine-is-non-inferior-to-full-dose-sugammadex-for-reversal-of-rocuronium-induced-deep-neuromuscular-blockade-a-cost-saving-strategy
#16
Marie T Aouad, Waseem S Alfahel, Roland N Kaddoum, Sahar M Siddik-Sayyid
BACKGROUND: Sugammadex reverses the effect of rocuronium more rapidly and effectively than neostigmine, at all levels of neuromuscular blockade (NMB). However, its cost is prohibitive. The combination of half dose sugammadex with neostigmine would be non-inferior to full dose sugammadex for the reversal of deep NMB. This approach would reduce the cost of sugammadex while preserving its efficacy. METHODS: Patients were randomly allocated to receive sugammadex 4 mg/kg (Group S) or sugammadex 2 mg/kg with neostigmine 50 μg/kg and glycopyrrolate 10 μg/kg (Group NS) for reversal of rocuronium deep NMB...
April 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28392946/management-of-residual-neuromuscular-blockade-recovery-age-old-problem-with-a-new-solution
#17
Michael S Green, Archana Gundigi Venkatesh, Ranjani Venkataramani
Neostigmine has been traditionally used as the agent of choice to reverse Neuromuscular Blockade (NMB) after muscle paralysis during general anesthesia. However, the use of neostigmine has not been without untoward events. Sugammadex is a novel drug that selectively binds to aminosteroid nondepolarizing muscle relaxants and reverses even a deep level of NMB. Controversy exists regarding the optimal dose of sugammadex that is effective in reversing the NMB after the incomplete reversal with neostigmine and glycopyrrolate...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28329602/glycopyrrolate-induced-craniofacial-compensatory-hyperhidrosis-successfully-treated-with-oxybutynin-report-of-a-novel-adverse-effect-and-subsequent-successful-treatment
#18
Megan E Prouty, Ryan Fischer, Deede Liu
Hyperhidrosis, or abnormally increased sweating, is a condition that may have a primary or secondary cause. Usually medication- induced secondary hyperhidrosis manifests with generalized, rather than focal sweating. We report a 32-year-old woman with a history of palmoplantar hyperhidrosis for 15 years who presented for treatment and was prescribed oral glycopyrrolate. One month later, the palmoplantar hyperhidrosis had resolved, but she developed new persistent craniofacial sweating. After an unsuccessful trial of clonidine, oxybutynin resolved the craniofacial hyperhidrosis...
October 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28298780/effects-of-inhaled-nitrous-oxide-on-the-induction-dose-and-time-requirements-of-propofol-a-prospective-randomized-double-blind-study
#19
Kavita Jain, Surendra Kumar Sethi, Mamta Damor, Neena Jain
CONTEXT: Propofol is a commonly used induction agent during general anesthesia. As a sole agent, it does not provide any strong analgesic effect. The nitrous oxide (N2O) used along with propofol for induction of anesthesia augments the induction characteristics and reduces the dose of propofol. AIMS: To study the effects of inhaled N2O on the induction dose and time of propofol during general anesthesia and also its hemodynamic response and adverse effects. SETTINGS AND DESIGN: The present research is a prospective, randomized, double-blind comparative study...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28183573/glycopyrrolate-it-s-time-to-review
#20
REVIEW
Jonathan Howard, Jason Wigley, Gerald Rosen, Jay D'mello
Medication shortages have become an all-too-common inconvenience that has forced anesthesia providers to examine our administering practices. Because of these shortages, commonly used medications are at the greatest risk. Glycopyrrolate (Robinul), which has been in short supply in recent years, is one of the most widely used anticholinergic agents, especially in conjunction with the anticholinesterase neostigmine, for reversal of neuromuscular blockade (NMB) drugs. Here we review multiple studies from 1972 through 1986 that used varying methods of patient selection and dosage and drug combination criteria, and which noted that glycopyrrolate had a superior efficacy and adverse effect profile when compared with atropine in NMB reversal...
February 2017: Journal of Clinical Anesthesia
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