PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “GLYCOPYRROLATE”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 613 records · Page 34Linked to original sources
PubMed1984

Quantitative capillary column gas chromatographic method for the determination of glycopyrronium in human plasma.

A new sensitive and selective capillary column gas chromatographic method for the anti-cholinergic agent glycopyrronium bromide in human plasma is described. The procedure involves preliminary ion-pair extraction of the drug into dichloromethane, followed by concentration and analysis of the ion-pair complex by capillary column gas chromatography using a nitrogen-sensitive detector. The method depends on the thermal dequaternisation of the quaternary ammonium compound and can be used to detect 5 ng/ml in a 3-ml plasma sample. The assay procedure has been applied to the determination of the plasma concentration of glycopyrronium after intravenous administration to an anaesthetised patient.

Benzilates↗
PubMed2002

Medical management of Meniere's disease.

Medical therapy of Meniere's disease is geared not only toward the differential diagnosis that has led to Meniere's disease and the supportive therapy for the physical manifestations of the disease but also for the psychologic sequelae of the disease such as mild-to-moderate situational depression and even chronic depression. Overall, with adequate medical therapy, allergy workup, and immunotherapy for patients with known diagnoses of allergies, the author's clinic has been able to help more than 85% of its patients who present with symptoms of Meniere's disease. For intractable cases where autoimmune phenomena can be suspected with a strong degree of suspicion, the author's clinic has also treated patients with immunosuppressive medications such as azathioprine and/or methotrexate in a low dose.

Adrenal Cortex Hormones↗
PubMed2000

Physiological response to ECT stimulus dose.

For a physiological effect to be useful to regulate the electrical stimulus dose used in electroconvulsive therapy (ECT), it must show sensitivity to the stimulus dose. In the analogy of using blood drug concentration to regulate drug dosage, this concentration must be sensitive to the dose. Accordingly, we examined the sensitivity of several physiological effects to ECT stimulus dose. Previously no substantial sensitivity of physiological effects was found when generally effective ECT methods were used. EEG post-ictal suppression, recruitment phase duration, wave form regularity and spike-and-wave frequencies, peak seizure heart rate (HR), and several types of seizure duration were measured with standard and higher dose stimuli given on separate days to 24 subjects. Left frontal to right temporal asymmetric bilateral stimulus placement was applied. Peak HR (P=0.007, t=2.7) and EEG recruitment phase duration (P=0.04, t=1.9) varied with stimulus dose, by 12 beats/min and 1.3 s, respectively. Only peak HR (P=0.02, t=2.2) varied with stimulus dose (by 6 beats/min) when subjects who showed only EEG seizure but no motor seizures were excluded. Subjects who maintained peak HR near their individual maximum values received fewer ECTs than other subjects (P=0.00003, t=5.20); this greater efficacy suggests that the peak HR reflects clinical efficacy as well as stimulus dose. In addition to EEG measurements, peak HR is a candidate to measure ECT seizure quality and provide feedback for stimulus dose regulation.

Adjuvants, Anesthesia↗
PubMed2000

Antisecretory agents in gastrointestinal obstruction.

Gastrointestinal obstruction is associated with nausea, vomiting, and abdominal pain. Antisecretory agents can relieve these symptoms, even in the absence of surgical or mechanical intervention. These medical management approaches are outlined, and recommendations are made.

Abdominal Pain↗
PubMed2003

Cholinergic enhancement modulates neural correlates of selective attention and emotional processing.

Neocortical cholinergic afferents are proposed to influence both selective attention and emotional processing. In a study of healthy adults we used event-related fMRI while orthogonally manipulating attention and emotionality to examine regions showing effects of cholinergic modulation by the anticholinesterase physostigmine. Either face or house pictures appeared at task-relevant locations, with the alternative picture type at irrelevant locations. Faces had either neutral or fearful expressions. Physostigmine increased relative activity within the anterior fusiform gyrus for faces at attended, versus unattended, locations, but decreased relative activity within the posterolateral occipital cortex for houses in attended, versus unattended, locations. A similar pattern of regional differences in the effect of physostigmine on cue-evoked responses was also present in the absence of stimuli. Cholinergic enhancement augmented the relative neuronal response within the middle fusiform gyrus to fearful faces, whether at attended or unattended locations. By contrast, physostigmine influenced responses in the orbitofrontal, intraparietal and cingulate cortices to fearful faces when faces occupied task-irrelevant locations. These findings suggest that acetylcholine may modulate both selective attention and emotional processes through independent, region-specific effects within the extrastriate cortex. Furthermore, cholinergic inputs to the frontoparietal cortex may influence the allocation of attention to emotional information.

Adult↗
PubMed2006

Soft quaternary anticholinergics: comprehensive quantitative structure-activity relationship (QSAR) with a linearized biexponential (LinBiExp) model.

A comprehensive quantitative structure-activity relationship (QSAR) study is presented for quaternary soft anticholinergics including two distinctly different classes designed on the basis of the soft analogue and the inactive metabolite approaches. Because of the clear biphasic (bilinear) nature of the activity data when all structures (n = 76) were considered as a function of molecular size (volume), a nonlinear model had to be used, and a linearized biexponential (LinBiExp) model proved very adequate. LinBiExp can fit activity data that show a maximum (or a minimum) around a given parameter value but tend to show linearity away from this turning point. Contrary to Hansch-type parabolic models, LinBiExp represents a natural extension of linear models, and a direct correspondence between its parameters and those obtained earlier by linear regression on compound subsets covering more limited parameter ranges could be easily established. Stereospecificity was confirmed as important, and the presence of an acid moiety was found to essentially eliminate activity. The consideration of bilinear behavior, which most likely results from size limitations at the binding site, can also explain the embarrassingly low activity found for a relatively large compound predicted as highly active by Lien, Ariëns, and co-workers based on their QSAR study.

Animals↗
PubMed1999

Ventricular fibrillation related to reversal of the neuromuscular blockade in a patient with long QT syndrome.

The long QT syndrome (LQTS) is associated with syncopal attacks or even sudden death at a young age due to ventricular fibrillation. We report a patient with an undiagnosed LQTS who had an episode of cardiac arrest during the final part of general anesthesia, immediately after the drugs for reversal of the neuromuscular blockade were given. We suggest that the administration of glycopyrronium might have been the provoking factor in this patient.

Adult↗
PubMed2003

Preoperative transcervical analgesia for laparoscopic sterilization with Filshie clips. A double blind randomized trial.

OBJECTIVE: To evaluate the use of preoperative transcervical analgesia for reducing postoperative pain from laparoscopic sterilization with Filshie clips. DESIGN: A double blind, randomized, placebo-controlled trial. SETTING: Gynecologic day-care clinic of Vejle Hospital, Vejle, Denmark. SAMPLE: Seventy-eight healthy women were attending the public hospital requesting sterilization. METHODS: Participants received bupivacaine 0.25% 20 mL or placebo normal saline 20 mL injected into the uterus, though the fallopian tubes and into the pelvis before tubal occlusion with Filshie clips. MAIN OUTCOME MEASURES: Post-operative visual analog pain score and request for analgesia were recorded. RESULTS: At 30 min after clip application there was a non-significant reduction in pain-score on VAS. However, at 1, 2, 3 and 4 h median pain score on VAS was similar in both groups. Patients request for postoperative analgesia was similar in the two groups. CONCLUSIONS: Preoperative transcervical perfusion of the uterus, fallopian tubes and into the pelvis did not reduce postoperative pain or request for analgesics after laparoscopic sterilization with Filshie clips.

Adjuvants, Anesthesia↗
PubMed1984

Effect of potassium chloride supplements on upper gastrointestinal mucosa.

Eight controlled 1- or 2-wk experiments involving 225 healthy male subjects and one study of 18 patients with hypertension, nine of whom were long-term users of a wax-matrix potassium chloride preparation, were conducted to evaluate the upper gastrointestinal safety of oral KCl supplements. All subjects in the short-term studies had normal upper gastrointestinal tracts. Subjects were examined again after at least 7 days of treatment with one of three commonly prescribed wax-matrix KCl tablets, KCl liquid, microencapsulated KCl, a potassium- sparer , or placebo. Some received an anticholinergic drug with treatment to induce delayed gastric motility. Diet and compliance to treatment regimens were controlled. Results indicate that upper mucosal injury, particularly erosions (43%) and ulcerations (11%), were more frequent after wax-matrix tablets. These changes occurred much less frequently after liquid KCl (0%), microencapsulated KCl (10.5% erosions, 1.2% ulcers), and the potassium-sparing drug (0%). More serious and more frequent lesions were associated with slowed motility. No occult bleeding was noted. Symptomatic complaints did not correlate with endoscopic findings. In the long-term study, patients with hypertension were examined endoscopically after 19 to 23 mo on KCl and again after 1 wk. Six of nine of the patients with hypertension treated for nearly 2 yr with a wax-matrix KCl supplement had significant lesions. One had developed ulceration after 7 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Delayed-Action Preparations↗
PubMed1999

Cholinergic induced mesenteric vasorelaxation in response to head-up tilt.

Central hypovolaemia induced by head-up tilt evokes a reduction in superior mesenteric artery resistance resulting in maintenance of regional blood flow. Mechanisms of importance for this response are not known, but a parasympathetic contribution could be expected. To evaluate this hypothesis, superior mesenteric artery blood flow and resistance were evaluated by duplex ultrasound in eight healthy volunteers during postprandial head-up tilt with and without cholinergic blockade. During supine rest, cholinergic blockade did not influence the postprandial reduction in peripheral mesenteric artery resistance as expressed by analogous elevations in the diastolic blood velocity (to 62 +/- 9 vs. 56 +/- 7 cm s-1 with placebo). Throughout the normotensive and hypotensive phases of head-up tilt, cholinergic blockade reduced mesenteric artery mean blood velocity by 39 and 42%, respectively, corresponding to volume flow reductions by 35 and 41% (0.62 +/- 0.10 vs. 0.96 +/- 0.13 L min-1 and 0.52 +/- 0.07 vs. 0.88 +/- 0.16 L min-1; P < 0.05). Also, during both phases of head-up tilt, cholinergic blockade increased mesenteric artery resistance as reflected in a reduction in the diastolic blood velocity by 41 and 56%, respectively (44 +/- 4 vs. 74 +/- 13 cm s-1 and 24 +/- 6 vs. 54 +/- 8 cm s-1). These results support a cholinergic contribution to the mesenteric artery vasorelaxing response to central hypovolaemia induced by head-up tilt.

Adult↗
PubMed2002

Glycopyrronium and hypotension following combined spinal-epidural anaesthesia for elective Caesarean section in women with relative bradycardia.

The ability of glycopyrronium to reduce the severity of hypotension following subarachnoid block in parturients with a relative bradycardia was evaluated in a double-blind randomised controlled study. Women with a resting heart rate of < or = 80 beat x min(-1) presenting for elective Caesarean section were randomly allocated to receive either glycopyrronium 2 microg x kg(-1) or normal saline intravenously once positioned for combined spinal-epidural anaesthesia. Following spinal injection of 2.6 ml hyperbaric bupivacaine 0.5% and fentanyl 15 microg, women randomly allocated to the saline group were given 6 mg ephedrine so that all parturients received some prophylaxis against hypotension other than the fluid preload. Further ephedrine and fluid boluses were administered if mean arterial pressure fell 20% or more from resting values. Using a sequential analysis technique, analysis after the first 20 subjects indicated the study should be stopped, with no difference in ephedrine requirements or hypotension between the groups. We conclude that pretreatment with glycopyrronium 2 microg x kg(-1) is no more effective than 6 mg ephedrine in preventing hypotension following subarachnoid block in parturients with relatively low resting heart rates.

Adult↗
PubMed1976

The value of a histamine H2-receptor antagonist in the management of patients with the Zollinger-Ellison syndrome.

Inhibition of acid secretion by an H2-receptor antagonist (metiamide) was assessed in three patients with the Zollinger-Ellison syndrome. Metiamide (200 or 300 mg) inhibited acid secretion transiently (2 1/2 hours) by 85 to 100 per cent in all patients. Although anticholinergic drugs alone inhibited acid secretion by only 0 to 35 per cent in these patients, the combination of metiamide and anticholinergic markedly prolonged the inhibitory effect of metiamide. Total gastrectomy was refused by one patient, and was impossible in another; both were treated with metiamide and anticholinergic for five and 10 months. A third patient was treated with metiamide and anticholinergic for three weeks in preparation for total gastrectomy. Ulcer pain and diarrhea disappeared, and each gained weight. H2-receptor antagonists may be useful in the treatment of some patients with the Zollinger-Ellison syndrome.

Adult↗