From the Guidelines
Glycohale is not a recognized medication in standard medical practice, and its indications are not established in the provided evidence. However, based on the information provided, it appears that glycopyrrolate, a medication that might be related to the query, is used in various contexts, including as an anticholinergic agent to reduce secretions and as a component of inhalers for chronic obstructive pulmonary disease (COPD) management 1.
Indications for Glycopyrrolate-Containing Medications
- Maintenance treatment of airflow obstruction in patients with COPD, including chronic bronchitis and emphysema, where glycopyrrolate acts as a long-acting muscarinic antagonist (LAMA) to relax airway smooth muscles by blocking acetylcholine receptors, thereby improving breathing 1.
- Reduction of excessive secretions associated with dyspnea in palliative care settings, where glycopyrrolate does not effectively cross the blood-brain barrier, making it less likely to cause delirium compared to other anticholinergic options 1.
- Prevention of bradycardia and management of arrhythmias in certain medical procedures, such as electroconvulsive therapy (ECT) and gastrointestinal endoscopy, where glycopyrrolate or atropine may be administered to protect the cardiovascular system from vagal discharge 1.
Important Considerations
- Proper Inhaler Technique: Patients using glycopyrrolate-containing inhalers should be instructed on proper inhaler technique to ensure effective medication delivery to the lungs.
- Side Effects and Contraindications: While glycopyrrolate has a favorable profile due to its limited ability to cross the blood-brain barrier, it can still produce anticholinergic side effects. Atropine, an alternative, can cause tachycardia, be pro-arrhythmogenic, and has other side effects like blurred vision and dryness of the mouth 1.
Given the information and focusing on the most recent and highest quality evidence, the primary indication for medications related to glycopyrrolate is the maintenance treatment of COPD, with other uses in palliative care and procedural settings based on the specific clinical context and patient needs 1.
From the FDA Drug Label
In Anesthesia Glycopyrrolate Injection is indicated for use as a preoperative antimuscarinic to reduce salivary, tracheobronchial, and pharyngeal secretions; to reduce the volume and free acidity of gastric secretions; and to block cardiac vagal inhibitory reflexes during induction of anesthesia and intubation When indicated, Glycopyrrolate Injection may be used intraoperatively to counteract surgically or drug-induced or vagal reflexes associated arrhythmias. Glycopyrrolate protects against the peripheral muscarinic effects (e.g., bradycardia and excessive secretions) of cholinergic agents such as neostigmine and pyridostigmine given to reverse the neuromuscular blockade due to non-depolarizing muscle relaxants. In Peptic Ulcer For use in adults as adjunctive therapy for the treatment of peptic ulcer when rapid anticholinergic effect is desired or when oral medication is not tolerated
The indications for Glycopyrrolate are:
- Anesthesia: as a preoperative antimuscarinic to reduce secretions and block cardiac vagal inhibitory reflexes
- Peptic Ulcer: as adjunctive therapy for the treatment of peptic ulcer when rapid anticholinergic effect is desired or when oral medication is not tolerated 2 2
From the Research
Glycopyrrolate Indications
Glycopyrrolate is used for various medical conditions, including:
- Asthma: Glycopyrrolate provides clinically significant, safe 12-hour bronchodilation in patients with asthma without severe airway obstruction 3
- Chronic Obstructive Pulmonary Disease (COPD): Inhaled glycopyrrolate is a fast-acting, efficacious treatment option for patients with moderate-severe COPD, improving lung function, reducing the risk of exacerbations, and alleviating symptoms of breathlessness 4
- Noisy respirations in adult hospice patients: Anticholinergic medications like glycopyrrolate are used to reduce noisy respirations from retained secretions in terminal patients 5
Key Benefits
- Prolonged bronchoprotection and bronchodilatation: Glycopyrrolate causes prolonged bronchoprotection and bronchodilatation in patients with asthma 6
- Improved lung function: Glycopyrrolate improves lung function, reduces the risk of exacerbations, and alleviates symptoms of breathlessness in patients with COPD 4, 7
- Safe and well-tolerated: Inhaled formulations containing glycopyrrolate are well-tolerated, with few cardiovascular-related events reported 4
Patient Response
- Reversible and nonreversible patients: Glycopyrrolate is effective in both reversible and nonreversible patients with COPD, with significant improvements in lung function and patient-reported outcomes 7
- Symptom improvement: Glycopyrrolate improves symptoms of breathlessness and reduces rescue medication use in patients with COPD 7