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Glycopyrrolate

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https://www.readbyqxmd.com/read/28183573/glycopyrrolate-it-s-time-to-review
#1
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
https://www.readbyqxmd.com/read/28129312/the-effect-of-glycopyrrolate-on-nocturnal-sialorrhea-in-patients-using-clozapine-a-randomized-crossover-double-blind-placebo-controlled-trial
#2
Wai Hong Man, Jantine C A Colen-de Koning, Peter F J Schulte, Wiepke Cahn, Ingrid M M van Haelst, Hieronymus J Doodeman, Toine C G Egberts, Eibert R Heerdink, Ingeborg Wilting
BACKGROUND: Nocturnal sialorrhea is one of the most frequent adverse events in clozapine treatment. Symptomatic management of sialorrhea usually consists of off-label treatment with anticholinergic agents. The aim of the current study is to evaluate the efficacy and safety of glycopyrrolate in patients using clozapine that experience sialorrhea. METHODS: In a double-blind randomized crossover trial, patients with nocturnal sialorrhea (n = 32) were randomized to treatment with glycopyrrolate 1 mg or placebo...
January 26, 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/28128660/cardiac-failure-in-a-trisomy-9-patient-undergoing-anesthesia-a-case-report
#3
Cara J Riley, Timothy Moore, Lauren Eagelston, Dale Burkett, Scott Auerbach, Richard J Ing
A 27-year-old female with Trisomy 9 mosaicism presented to Children's Hospital Colorado for outpatient dental surgery under general anesthesia. The patient's past medical history was also significant for premature birth, gastroesophageal reflux, scoliosis and kyphosis, obesity, and developmental delay. Per her mother's report, the patient had no cardiac issues. She had undergone multiple previous general anesthetics, some of which documented respiratory complications such as laryngospasm, bronchospasm, and possible aspiration...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28128284/sensory-and-autonomic-function-and-structure-in-footpads-of-a-diabetic-mouse-model
#4
Ying Liu, Blessan Sebastian, Ben Liu, Yiyue Zhang, John A Fissel, Baohan Pan, Michael Polydefkis, Mohamed H Farah
Sensory and autonomic neuropathy affects the majority of type II diabetic patients. Clinically, autonomic evaluation often focuses on sudomotor function yet this is rarely assessed in animal models. We undertook morphological and functional studies to assess large myelinated and small unmyelinated axons in the db/db type II diabetes mouse model. We observed that autonomic innervation of sweat glands in the footpads was significantly reduced in db/db mice compared to control db/+ mice and this deficit was greater compared to reductions in intraepidermal sensory innervation of adjacent epidermis...
January 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28093070/clonidine-is-effective-for-the-treatment-of-primary-idiopathic-hyperhidrosis-and-hot-flushes-a-case-report
#5
Ahmed Albadrani
BACKGROUND: While primary hyperhidrosis can be seen in men, accompanying hot flushes is rarely seen in men. Primary hyperhidrosis is thought to be related to overactivity of the sympathetic nervous system while hot flushes are believed to be related to altered peripheral vascular reactivity and a narrowed thermoregulatory zone. CASE PRESENTATION: I report the case of a 29-year-old man of Arab origin who presented to a dermatology clinic with a complaint of generalized sweating, with heavier involvement of his inguinal region, axilla, and lower back...
January 17, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28081026/the-effect-of-nebulized-glycopyrrolate-on-posterior-drooling-in-patients-with-brain-injury-two-cases-of-different-brain-lesions
#6
Zee-Ihn Lee, Kwang Jae Yu, Dae Hee Lee, Seong Kyung Hong, Seung Beom Woo, Jong Min Kim, Donghwi Park
Posterior drooling, which can lead to substantial respiratory morbidity, including unexplained lung diseases and recurrent pneumonia, is an important issue in the rehabilitation unit. There are various treatment options for posterior drooling, including pharmacologic therapy, oral motor or behavioral therapy, biofeedback, local glandular injection of botulinum toxin, irradiation, and surgery. Among them, nebulized glycopyrrolate has the following advantages: It is noninvasive and is relatively free of central adverse effects because it does not cross the blood-brain barrier unlike other anticholinergics...
January 9, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28061907/a-randomized-seven-day-study-to-assess-the-efficacy-and-safety-of-a-glycopyrrolate-formoterol-fumarate-fixed-dose-combination-metered-dose-inhaler-using-novel-co-suspension%C3%A2-delivery-technology-in-patients-with-moderate-to-very-severe-chronic-obstructive-pulmonary
#7
Colin Reisner, Leonardo M Fabbri, Edward M Kerwin, Charles Fogarty, Selwyn Spangenthal, Klaus F Rabe, Gary T Ferguson, Fernando J Martinez, James F Donohue, Patrick Darken, Earl St Rose, Chad Orevillo, Shannon Strom, Tracy Fischer, Michael Golden, Sarvajna Dwivedi
BACKGROUND: Long-acting muscarinic antagonist/long-acting β2-agonist combinations are recommended for patients whose chronic obstructive pulmonary disease (COPD) is not managed with monotherapy. We assessed the efficacy and safety of glycopyrrolate (GP)/formoterol fumarate (FF) fixed-dose combination delivered via a Co-Suspension™ Delivery Technology-based metered dose inhaler (MDI) (GFF MDI). METHODS: This was a Phase IIb randomized, multicenter, placebo-controlled, double-blind, chronic-dosing (7 days), crossover study in patients with moderate-to-very severe COPD ( NCT01085045 )...
January 6, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28024715/incidence-of-postoperative-nausea-and-vomiting-following-gynecological-laparoscopy-a-comparison-of-standard-anesthetic-technique-and-propofol-infusion
#8
Pradipta Bhakta, Bablu Rani Ghosh, Umesh Singh, Preeti S Govind, Abhinav Gupta, Kulwant Singh Kapoor, Rajesh Kumar Jain, Tulsi Nag, Dipanwita Mitra, Manjushree Ray, Vikash Singh, Gauri Mukherjee
OBJECTIVE: To determine the safety, efficacy, and feasibility of propofol-based anesthesia in gynecological laparoscopies in reducing incidences of postoperative nausea and vomiting compared to a standard anesthesia using thiopentone/isoflurane. DESIGN: Randomized single-blind (for anesthesia techniques used) and double-blind (for postoperative assessment) controlled trial. SETTING: Operation theater, postanesthesia recovery room, teaching hospital...
December 23, 2016: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
https://www.readbyqxmd.com/read/27976476/treatment-of-primary-hyperhidrosis-with-oral-anticholinergic-medications-a-systematic-review
#9
REVIEW
Lucinda Cruddas, Daryll M Baker
BACKGROUND: Primary hyperhidrosis is a condition characterised by excessive sweating. Patients are treated off-license with oral anticholinergic medications, and report adverse events associated with systemic anticholinergic interactions. OBJECTIVES: This review assesses clinical evidence of efficacy, impact on quality of life and adverse events associated with oral anticholinergic therapy for primary hyperhidrosis. METHODS: PRISMA guidelines were implemented to complete a systematic review (PROSPERO:CRD42016036326)...
December 15, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/27966225/parasympathetic-withdrawal-increases-heart-rate-after-2%C3%A2-weeks-at-3454%C3%A2-m-altitude
#10
Christoph Siebenmann, Peter Rasmussen, Mike Hug, Stefanie Keiser, Daniela Flück, James P Fisher, Matthias P Hilty, Marco Maggiorini, Carsten Lundby
KEY POINTS: Heart rate is increased in chronic hypoxia and we tested whether this is the result of increased sympathetic nervous activity, reduced parasympathetic nervous activity, or a non-autonomic mechanism. In seven lowlanders, heart rate was measured at sea level and after 2 weeks at high altitude after individual and combined pharmacological inhibition of sympathetic and/or parasympathetic control of the heart. Inhibition of parasympathetic control of the heart alone or in combination with inhibition of sympathetic control abolished the high altitude-induced increase in heart rate...
December 14, 2016: Journal of Physiology
https://www.readbyqxmd.com/read/27939204/role-of-glycopyrrolate-in-healing-of-anastomotic-dehiscence-after-primary-repair-of-esophageal-atresia-in-a-low-resource-setting-a-randomized-controlled-study
#11
Mahesh Manilal Vaghela, J K Mahajan, Jegadeesh Sundram, Neerja Bhardwaj, K L N Rao
AIMS: To investigate the role of glycopyrrolate in decreasing oral secretions in patients of esophageal atresia (EA) with anastomotic leak and evaluate its effect on healing of anastomotic dehiscence. METHODS: The study comprised consecutive neonates of esophageal atresia, who had undergone primary surgery and developed anastomotic leak. The patients were randomized into two groups with the observer blinded to the group. The patients in the treatment group were administered glycopyrrolate in the dose of 8 μg/kg 8 hourly, whereas placebo group patients were injected normal saline only...
November 23, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27927039/muscarinic-antagonists-in-early-stage-clinical-development-for-the-treatment-of-asthma
#12
Timothy E Albertson, James A Chenoweth, Jason Y Adams, Mark E Sutter
Parasympathetic neurons utilize the neurotransmitter acetylcholine to modulate and constrict airway smooth muscles at the muscarinic acetylcholine receptor. Inhaled agents that antagonize the muscarinic (M) acetylcholine receptor, particularly airway M3 receptors, have increasing data supporting use in persistent asthma. Areas covered: Use of inhaled long-acting muscarinic antagonists (LAMA) in asthma is explored. The LAMA tiotropium is approved for maintenance in symptomatic asthma patients despite the use of inhaled corticosteroids (ICS), leukotriene receptor antagonists (LTRA) and/or long-acting beta2 agonists (LABA)...
January 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27924195/effects-of-glycopyrrolate-premedication-on-preventing-postoperative-catheter-related-bladder-discomfort-in-patients-receiving-ureteroscopic-removal-of-ureter-stone
#13
Jin A Kim, Jin Hye Min, Hong Sik Lee, Hyong Rae Jo, Ui Jin Je, Jin Hyub Paek
BACKGROUND: Glycopyrrolate given as reversing agents of muscle relaxants has been reported to be effective in reducing postoperative catheter-related bladder discomfort (CRBD). However, it remains unclear whether glycopyrrolate as premedication is also effective. This study aims to investigate the effectiveness of glycopyrrolate as premedication on preventing CRBD in the post-anesthesia care unit (PACU). METHODS: Eighty-three patients who received elective ureteroscopic removal of ureteral stone were randomly assigned to the control (n = 43) or the glycopyrrolate group (n = 40)...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27916620/efficacy-and-safety-of-glycopyrrolate-formoterol-mdi-formulated-using-co-suspension%C3%A2-delivery-technology-in-patients-with-copd
#14
Fernando J Martinez, Klaus F Rabe, Gary T Ferguson, Leonardo M Fabbri, Stephen Rennard, Gregory J Feldman, Sanjay Sethi, Selwyn Spangenthal, Gregory M Gottschlich, Roberto Rodriguez-Roisin, Samir Arora, Thomas M Siler, Shahid Siddiqui, Patrick Darken, Tracy Fischer, Andrea Maes, Michael Golden, Chad Orevillo, Colin Reisner
BACKGROUND: Long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA) combinations are a treatment option for patients with chronic obstructive pulmonary disease (COPD) who continue to have symptoms despite treatment with a LAMA or LABA alone. OBJECTIVES: The PINNACLE-1 (NCT01854645) and -2 (NCT01854658) trials investigated the efficacy and safety of a novel GFF MDI (glycopyrrolate [GP]/formoterol [FF] 18/9.6 μg metered dose inhaler [MDI]) formulated using Co-Suspension™ Delivery Technology, in patients with moderate-to-very severe COPD...
December 1, 2016: Chest
https://www.readbyqxmd.com/read/27872944/-multiple-eccrine-hidrocystomas-on-the-lower-forehead-and-nose-of-a%C3%A2-60-year-old-man
#15
J K Winkler, W Hartschuh, A Enk, F Toberer
Multiple eccrine hidrocystomas are benign cystic skin lesions which originate from the sweat gland ducts and typically affect women's midfacial area. Sweating may lead to an increase in size of the translucent papules. In some cases hidrocystomas are associated with other diseases such as Parkinson's disease. Treatment options include laser, topical and systemic anticholinergic drugs (glycopyrrolate, clonidine, atropine, and oxybutynin), whereby therapeutic success is limited in most cases.
November 21, 2016: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/27871593/atropine-and-glycopyrrolate-do-not-support-bacterial-growth-safety-and-economic-considerations
#16
Balazs Ittzes, Zsolt Weiling, Istvan Zoard Batai, Monika Kerenyi, Istvan Batai
STUDY OBJECTIVE: Evaluation of bacterial growth in atropine and glycopyrrolate. DESIGN: Laboratory investigation. SUBJECTS AND MEASUREMENTS: Standard microbiological methods were used to evaluate the impact of atropine and glycopyrrolate on the growth of Acinetobacter baumannii, Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli. Bacterial count was checked at 0, 1, 2, 3, 4, 6, and 24 hours. MAIN RESULTS: Atropine or glycopyrrolate did not support the growth of the above bacteria at any examined time at room temperature...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871505/operating-room-discharge-after-deep-neuromuscular-block-reversed-with-sugammadex-compared-with-shallow-block-reversed-with-neostigmine-a-randomized-controlled-trial
#17
Laurie Putz, Christophe Dransart, Jacques Jamart, Maria-Laura Marotta, Geraldine Delnooz, Philippe E Dubois
OBJECTIVE: To determine if reversing a deep or moderate block with sugammadex, compared with a shallow block reversed with neostigmine, reduces the time to operating room discharge after surgery and the time spent in the postanesthesia care unit. DESIGN: A randomized controlled trial. SETTING: Monocentric study performed from February 2011 until May 2012. PATIENTS: One hundred consenting women with American Society of Anesthesiologists grade I or II were randomized into 2 groups...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871302/glycopyrrolate-in-comparison-to-hyoscine-hydrobromide-and-placebo-in-the-treatment-of-hypersalivation-induced-by-clozapine-gothic1-study-protocol-for-a-randomised-controlled-feasibility-study
#18
Inti Qurashi, Simon Chu, Nusrat Husain, Richard J Drake, Imran Chaudhry, J F W Deakin
BACKGROUND: Clozapine is the only medication licensed for the treatment of resistant schizophrenia in the UK. Although efficacious, a common and unpopular side effect of clozapine treatment is clozapine-induced hypersalivation (CIH), which can contribute to non-adherence. The standard treatment for CIH in the UK is hyoscine hydrobromide but this may aggravate cognitive deficits in patients with schizophrenia while glycopyrrolate may be an effective alternative with a more tolerable side effect profile...
November 21, 2016: Trials
https://www.readbyqxmd.com/read/27861265/drug-updates-and-approvals-2016-in-review
#19
Lindsy Meadowcraft, Geoffrey Mospan, Taylor Morrisette, Katie Smart, Melissa Janis
In 2016, the FDA approved several new drugs for use in primary care. These drugs include amphetamine extended-release orally disintegrating tablets (Adzenys XR-ODT), elbasvir and grazoprevir (Zepatier), emtricitabine and tenofovir alafenamide (Descovy), glycopyrrolate and formoterol (Bevespi Aerosphere), insulin degludec injection (Tresiba), and ixekizumab (Taltz).
December 16, 2016: Nurse Practitioner
https://www.readbyqxmd.com/read/27817811/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-severe-copd
#20
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
BACKGROUND: This study formed part of the dose selection for a glycopyrrolate (GP)/formoterol fumarate (FF) fixed-dose combination formulated using novel Co-Suspension™ Delivery Technology and delivered via a metered dose inhaler (GFF MDI). The study aimed to confirm the optimal dose of GP to formulate with FF 9.6 μg in the fixed-dose combination product, GFF MDI. METHODS: This multicenter, randomized, double-blind, chronic-dosing, balanced incomplete block, crossover study (NCT01587079) compared five doses of GFF MDI (18/9...
November 2016: Respiratory Medicine
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