Glycopyrronium Bromide

📘 About

• Always check the BNF for latest prescribing advice.
• Glycopyrronium bromide is an antimuscarinic anticholinergic drug.
• Unlike some antimuscarinics, it does not cross the blood–brain barrier 🧠🚫 → fewer central nervous system effects.

⚙️ Mode of Action

• Blocks muscarinic acetylcholine receptors (anticholinergic effect).
• Reduces smooth muscle spasm in the bowel → relieves colic.
• Decreases salivary and respiratory secretions 💧 → useful in palliative care.

💊 Indications & Example Doses

• Bowel colic in palliative care.
• Excessive respiratory secretions (“death rattle”) in palliative care.
• Typical dosing: • 200 micrograms SC every 4 hours as needed. • 0.6–1.2 mg SC over 24 hours via syringe driver (continuous infusion).

Always check BNF or local guidelines for patient-specific adjustments.

🔄 Interactions

• See BNF for full list.
• May have additive effects with other anticholinergics (urinary retention, constipation, dry mouth).

⚠️ Cautions

• Risk of confusion, particularly in frail or elderly patients 👵🧓.
• Use with caution in patients with cardiac disease (arrhythmia risk).

🚫 Contraindications

• See BNF – no absolute contraindications in palliative use, but use cautiously in narrow-angle glaucoma or severe urinary retention.

💥 Side Effects

• Cardiac: Arrhythmias ❤️.
• CNS: Drowsiness, dizziness.
• Respiratory: Cough.
• GI/other: Dry mouth 👄, headache, nausea.

📖 References

• BNF – Glycopyrronium bromide

📝 Revisions

• September 2025 – Reformatted with bullet points, added emojis for clarity, and expanded cautions/side effects.