Glycopyrrolate Pharmacology

Real Life Pharmacology - Pharmacology Education for Health Care Professionals

Eric Christianson, PharmD; Pharmacology Expert and Clinical Pharmacist

Education, Health & Fitness, Medicine

5 • 716 Ratings

🗓️ 20 November 2025

⏱️ 12 minutes

🔗️ Recording | iTunes | RSS

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Summary

Glycopyrrolate is an anticholinergic medication commonly used to reduce excessive secretions, particularly in palliative care, postoperative settings, and certain neurologic conditions. It works by blocking acetylcholine at muscarinic receptors, which decreases salivary and respiratory secretions. Clinically, glycopyrrolate is often used to manage terminal respiratory secretions (“death rattle”). Adverse effects of glycopyrrolate are primarily related to its anticholinergic properties. These may include dry mouth, constipation, urinary retention, blurred vision, tachycardia, and decreased sweating. While it has fewer central effects than agents like scopolamine, caution is still warranted in patients with glaucoma, gastrointestinal obstruction, or significant urinary retention risk. Monitoring hydration and bowel function is important, especially in elderly or frail patients. Dosing strategies depend on the clinical need. In palliative care, low doses may be given subcutaneously or intravenously every 4–6 hours as needed, while oral dosing is common for chronic sialorrhea. Clinicians should consider the patient’s overall medication burden, as cumulative anticholinergic load can worsen cognitive impairment and contribute to falls or constipation. I discuss drug interactions and other commonly used medications that may contribute to anticholinergic burden.

Transcript

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0:00.0	Hey all, welcome back to the real-life pharmacology podcast. I'm your host, pharmacist, Eric Christensen.
0:05.3	Thank you so much for listening today. As always, go check out the top 200 drugs. It's a great
0:11.8	study guide, great refresher, absolutely free PDF to use. That's at real-life pharmacology.com.
0:24.2	Again, 31-page PDF on the top 200 drugs. I highlight some of the most important things you're going to see in clinical practice as well as those things that
0:30.1	frequently show up on board exams and pharmacology exams throughout your career. So go check that out, real-life pharmacology.com.
0:41.0	All right, the drug of the day today is glycopyrlate.
0:46.1	This is an anticholinergic type medication.
0:49.9	Where I've seen it use the most in my primarily geriatric practice is hospice-type situations to help dry up secretions.
1:01.4	The brand name of this medication is robinol, which that brand name production has discontinued, I believe, but the generic is still available.
1:12.6	So again, this medication being an antich colonergic medication, works at muscarinic receptors.
1:21.0	So it's a muscarinic receptor antagonist on smooth muscles.
1:26.4	And ultimately, what this does is it works on secretory glands, particularly in the mouth
1:35.1	and the upper respiratory tract.
1:37.8	And it essentially dries those up or can help with that.
1:43.0	So in end of life hospice type situations, you may see
1:47.4	excessive secretions from a patient and glycopyrolate is one of the potential medications
1:57.2	we could use to help with those secretions.
2:01.8	Now, another one I see commonly used in practice, probably more commonly, is atropine drops to the mouth as well.
2:12.1	So, again, glycopyrlate, another medication that works along the lines of atropine as well to dry up
2:20.0	those secretions.
2:22.5	Now we do have the potential for other uses of this medication.
2:28.2	I can tell you from my experience, I do not see these very often at all.
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