Supotaria IM/IV 0.2mg/ml Injection 1pc

Uses of Supotaria IM/IV 0.2mg/ml Injection

• Chronic obstructive pulmonary disease (COPD)

How does Supotaria IM/IV 0.2mg/ml Injection work?

It works by blocking the activity of a chemical messenger (acetylcholine) in the brain.

Side Effects of Supotaria IM/IV 0.2mg/ml Injection

• Common: Dry mouth, constipation, urinary retention, tachycardia, blurred vision, drowsiness, confusion (especially in the elderly), nausea, vomiting, dry skin.
• Serious: Tachycardia, ventricular fibrillation, arrhythmias, hypertension, anaphylaxis, respiratory arrest, and hyperpyrexia.

Quick Suggestions:

• You have been prescribed Glycopyrrolate to reduce excessive drooling or salivation.
• Take it at least 1 hour before or 2 hours after a meal.
• It may cause constipation. Eat adequate fiber in your diet and drink plenty of water.
• Use caution while driving or doing anything that requires concentration as Glycopyrrolate may cause dizziness and blurred vision.
• It may make you sweat less. Avoid doing things that may cause you to overheat such as exercise.
• Inform your doctor if you develop nausea, vomiting, constipation, or diarrhea that does not go away.

Indications:

In Anesthesia:

1. Pre-operative use to reduce salivary, tracheobronchial, and pharyngeal secretions and decrease gastric acidity.
2. Intraoperative use to prevent bradycardia caused by suxamethonium or cardiac vagal reflexes.
3. Protection against muscarinic effects of anticholinesterases (e.g., neostigmine, pyridostigmine) used to reverse neuromuscular blockade by non-depolarizing muscle relaxants.

In Peptic Ulcer:

• As adjunctive therapy for treating peptic ulcers when rapid anticholinergic effects are needed or oral medication is not tolerated

Pharmacology

• Mechanism of Action: Glycopyrronium bromide is an antimuscarinic agent that competitively inhibits the action of acetylcholine at muscarinic receptors. This leads to reduced secretions (salivary, bronchial, sweat), increased heart rate, dilated pupils (mydriasis), and decreased gastrointestinal motility and gastric acid secretion.
• Characteristics: Quaternary ammonium compound with limited lipid solubility, minimizing central nervous system effects.

Dosage & Administration of Supotaria IM/IV 0.2mg/ml Injection

Pre-anesthetic Use:

• Adults: 0.2-0.4 mg IV/IM before anesthesia induction or 0.004-0.005 mg/kg (up to 0.4 mg).
• Children (1 month to 12 years): 0.004-0.008 mg/kg IV/IM before anesthesia induction (max 0.2 mg).

Intraoperative Use:

• Adults: 0.2-0.4 mg IV (or 0.004-0.005 mg/kg, max 0.4 mg); repeat if necessary.
• Children: 0.004-0.008 mg/kg IV (max 0.2 mg); repeat if necessary.

Reversal of Neuromuscular Blockade:

• Adults: 0.2 mg IV per 1 mg neostigmine or 0.01-0.015 mg IV with 0.05 mg/kg neostigmine.
• Children: 0.01 mg/kg IV with 0.05 mg/kg neostigmine.

Overdose Effects

• Symptoms: Peripheral anticholinergic effects.
• Management: Administer IV neostigmine methylsulphate (0.25 mg increments in adults, smaller doses for children) every 5-10 minutes until symptoms reverse, up to 2.5 mg max.

Interaction

• Increased Antimuscarinic Effects: With amantadine, tricyclic antidepressants, antihistamines, clozapine, disopyramide, MAOIs, nefopam, pethidine, and phenothiazines.
• Other Interactions: Delayed absorption of medications, increased intraocular pressure with corticosteroids, antagonism with gastro-intestinal activity modifiers (e.g., domperidone, metoclopramide), reduced ketoconazole absorption, and altered levodopa

Contraindications

Angle-closure glaucoma; myasthenia gravis (large doses of quaternary ammonium compounds have been shown to block end plate nicotinic receptors); paralytic ileus; pyloric stenosis; prostatic enlargement. Anticholinesterase-antimuscarinic combinations such as neostigmine plus glycopyrronium should be avoided in patients with a prolonged QT interval.

Pregnancy & Lactation

Data on the use of glycopyrronium bromide in pregnant women, other than on delivery, are not forthcoming, nor is there documentation concerning excretion in breast milk. Although glycopyrronium bromide does not readily cross the placenta, the injection should only be prescribed to pregnant women when necessary. Caution is advised when considering administration to a lactating mother.

Precautions & Warnings

• Use with Caution: In Down’s syndrome, children, elderly, patients with gastroesophageal reflux disease, ulcerative colitis, hypertension, cardiac insufficiency, tachycardia conditions, and during pregnancy and lactation.
• Special Populations: Higher risk of side effects in children and elderly. Not recommended for long-term use in pediatric patients.

Storage Conditions:

Store below 25°C, protected from light and moisture. Keep out of reach of children.