Glycopyrrolate

(Robinul)

Neuromuscular Blocking Agents & Reversals

Glycopyrrolate is a quaternary ammonium anticholinergic used to counteract the muscarinic effects of neostigmine during neuromuscular blockade reversal. Compared to atropine, it has more potent inhibition of salivary and bronchial secretions with less tachycardia and CNS effects. Glycopyrrolate does not cross the blood-brain barrier, avoiding central anticholinergic syndrome. The drug is particularly valuable in cardiac patients where excessive tachycardia should be avoided. Glycopyrrolate's onset matches well with neostigmine when given simultaneously. It is also used preoperatively to reduce secretions and intraoperatively to treat bradycardia.