From the FDA Drug Label
- 5 Anticholinergic Drug Effects
Use glycopyrrolate oral solution with caution in patients with conditions that are exacerbated by anticholinergic drug effects including: ... Coronary heart disease, congestive heart failure, cardiac tachyarrhythmias, tachycardia, and hypertension
The patient is experiencing tachycardia after taking glycopyrrolate (Robinul), which is a potential side effect of the medication, especially in patients with pre-existing heart conditions.
- Monitor the patient's heart rate and blood pressure closely.
- Adjust the dose of glycopyrrolate or consider alternative treatments if the tachycardia persists or worsens.
- Consult with a cardiologist or the patient's primary care physician for further guidance on managing the patient's condition. 1
From the Research
Glycopyrrolate (Robinul) can cause tachycardia as a side effect due to its anticholinergic properties, and for symptomatic or severe tachycardia, consider administering a beta-blocker like metoprolol 5mg IV slowly (if not contraindicated by conditions like asthma, heart block, or heart failure) as the most effective treatment option, as supported by the study 2. When you block muscarinic receptors with glycopyrrolate, you remove the parasympathetic "brake" on heart rate, allowing sympathetic tone to dominate and increase heart rate. For mild tachycardia without symptoms, monitor the patient closely as it may resolve on its own. Ensure the patient is well-hydrated, as dehydration can worsen tachycardia. Document the reaction in the patient's chart and avoid future use of anticholinergics if possible. The severity of this reaction depends on the dose given, the patient's underlying autonomic tone, and individual sensitivity to anticholinergic effects. Elderly patients and those with cardiovascular disease may be more susceptible to this side effect. This tachycardia is an expected pharmacological effect rather than an allergic reaction. Some key points to consider when treating tachycardia caused by glycopyrrolate include:
- Monitoring the patient's heart rate and blood pressure closely
- Administering a beta-blocker like metoprolol if symptoms are severe or persistent
- Ensuring the patient is well-hydrated to prevent dehydration from worsening tachycardia
- Documenting the reaction in the patient's chart and avoiding future use of anticholinergics if possible
- Being aware of the potential for increased susceptibility to this side effect in elderly patients and those with cardiovascular disease, as noted in the study 3.