Robinul/Glycopyrrolate Thoughts

[Narrowminded]

Hi all,

I am not a Dr. and I don’t play one on TV. I’m just a CALS who pays very close attention to what meds my PALS is on and how they affect him. I want to relate something I’ve learned so that you may be aware of a possible side effect of this medication.

Brian has been on Robinul for something like 5 years, with the dose increasing over that time. For the most part it has been a huge help with his mucous overflow.

Over the past 6 months or so, it hasn’t seemed to be doing much good and I hesitated to again increase the dose. According to his physician, 8mg/day is the max. Brian was on 6.

At Mother’s Day, he started having some issues. His SATS going down and being very hard to bring up, even with a lot of O2. (For those that don’t know, he’s been vented almost 8 years). His BP will go up and his HR will also increase.

This issue seemed to come and go. Sometimes he would get very dry and I would remove the Robinul as no need. I noticed after removing it, his SATS would then go back to normal very quickly and the O2 could be reduced quite quickly with out losing any situation.

Over the past 2 weeks we have again had this issue and my poor kids struggled mightily while I got a few days of respite away. When I got back I cut the Robinul, as soon as 24 hours of it being out of his system happened, the O2 shot to normal and he is now back off of the 5L they had him on just trying to get him close to normal.

We did increase meds of anxiety during that time, but nothing was changing with the oxygen saturation. This made him have feelings of air hunger and just shot the anxiety higher.

Since this was the second time removal of Robinul has affected his oxygen level I just wanted others to be aware that this is a possible side effect. For us it took years of being on it to show.

Take it for what it is worth and always consult with your physician if you have any concerns. I am just relating what happened to us.

Hugs

 

[KarenNWendyn]

Robinol (Glycopyrrolate) is an anticholinergic drug that is supposed to open up the airways (bronchodilator). It works differently than most other bronchodilators such as Albuterol which are beta2 agonists.

I wasn’t familiar with Robinol. Here’s what I found out:

Potential adverse effects:
• Bronchospasm: Paradoxical bronchospasm may occur with the use of inhaled agents which may be life-threatening; discontinue use immediately and consider other therapy if bronchospasm occurs.

Sue, in your infinite spare time, you could play a doctor on TV

 

[Narrowminded]

Thank you Karen, you are too kind.

He was getting the oral through his g-tube, but it seems it did cause that even though it was given orally vs. inhaled.

Thanks for doing the research since you probably have access to better sites on the web/or books like the PDR, than the lay person can get to.

Hugs

 

[lgelb]

The consumer version of Rxlist notes the following interactions at a high level (you can always check potential interactions given a list of all drugs and supplements someone is taking, on drugs.com).

kidney disease;
heart disease or a heart rhythm disorder;
a stomach disorder such as hiatal hernia, reflux disease, or slow digestion;
a colostomy or ileostomy;
a thyroid disorder;
high blood pressure;
vision problems; or
a nerve disorder that causes numbness or tingling.

There are many other warnings and precautions, e.g. mixing with other anticholinergics like certain antidepressants (TCAs).

Oh, and here's the PDR link for those who prefer it.

 

[Narrowminded]

Laurie thank you for the PDR link. Fortunately Brian is on very few meds. Propanolol and Zoloft. Neither listed, by brand or chemical.

Will keep my eyes pealed as the days move forward.

 

[Nikki J]

Search for prescribing information for whatever you want to look up.