GLYCOSTING
GLYCOPYRROLATE AND NEOSTIGMINE · by BAJWA
Composition
Inj: Per ml amp: Glycopyrrolate 0.5 mg, neostigmine methylsulphate 2.5 mg.
Indications & Dosage
Reversal of residual non-depolarizing (competitive) neuromuscular block: BY IV INJ: Adults: 1-2 ml over a period of 10-30 sec; alternatively 0.02 ml/kg intravenously over a period of 10-30 sec. Children: 0.02 ml/kg IV over a period of 10-30 sec. Alternatively dilute to 10 ml with water for injection or 0.9% sodium chloride injection and administer 1 ml:./5 kg body weight. These doses may be repeated if adequate reversal of neuromuscular blockade is not achieved, max dose 2 ml.
Contraindications
Acute haemorrhage, ulcerative colitis, narrow-angle glaucoma, tachycardia, obstructive uropathy, paralytic ileus, obstructive disease of GI tract, myasthenia gravis, hypersensitivity to glycopyrrolate or any component of the formulation, intestinal or urinary obstruction.
Precautions
Bronchial asthma, cardiac disease, vagotonia, epilepsy, Parkinsonism, elderly, patients with autonomic neuropathy, hepatic or renal disease, ulcerative colitis may predispose megacolon, hyperthyroidism, CAD, CHF, arrhythmias, tach-ycardia, BPH, hiatus hernia with reflux.
Interactions
Cyclopropane or halothane anaesthesia. Depo-larising muscle relaxants.
Pregnancy
Risk cannot be ruled out.
Lactation
Contraindicated or not
Side Effects
Nausea, vomiting, dry skin, constipation, dry throat, dry mouth, irritation at injection site, dry nose, diaphoresis diarrhoea and abdominal cramp