Supotaria 0.2 IM/IV Injection 1 ml (1 Pcs)

Supotaria 0.2 is used to treat Chronic obstructive pulmonary disease (COPD). This medicine helps the muscles around the lungs to stay relaxed and reduces symptoms of diseases like coughing, chest tightness and shortness of breath. Your doctor will tell you how often you need to use your inhaler. It is important that you take the lowest dose needed to effectively control your chronic obstructive pulmonary disease (COPD). The effect of this medicine may be noticeable after a few days but will only reach its maximum after a few weeks. This medicine must be used regularly to be effective, so go on taking it even if you do not have any symptoms. That means it is doing its job. If you stop taking it your chronic obstructive pulmonary disease (COPD) may get worse. Thus, it should not be used to relieve sudden breathing problems. It is best to take the first dose of this medicine under medical supervision as it may cause wheezing or tightening of the airways. The most common side effects are runny nose, upper respiratory tract infection, and sore throat. If you get these, do not stop taking it but do talk to your doctor. You can help prevent these symptoms by rinsing your mouth and throat with water or brushing your teeth after using your inhaler. There are other, rarer side effects which can be serious. Talk to your doctor if you are worried about them.

Uses of Supotaria 0.2

• Chronic obstructive pulmonary disease (COPD)

Side effects of Supotaria 0.2

Common

• Runny nose
• Sore throat
• Upper respiratory tract infection

How to use Supotaria 0.2

Take this medicine in the dose and duration as advised by your doctor. Do not chew, crush or break it.

How Supotaria 0.2 works

Supotaria 0.2 is an anticholinergic medication. It works by blocking the activity of a chemical messenger (acetylcholine) in the brain. This helps the muscles around the lungs stay relaxed and reduces COPD symptoms such as coughing, chest tightness, and shortness of breath.

Quick Tips

• Supotaria 0.2 is used for long-term management of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD).
• This medicine is for inhalation using a nebuliser only. The solution should not be injected or swallowed.
• It does not work right away and should not be used to relieve sudden breathing problems.
• Take the first dose of this medicine under medical supervision as it may cause wheezing or tightening of the airways (bronchospasm) immediately after using.
• Avoid getting this medication into your eyes. It may cause eye pain/irritation, temporary blurred vision, and other vision changes.
• Inform your doctor if you have difficulty passing urine or have painful urination.

Brief Description

Indication

In Anesthesia: • As a pre-operative antimuscarinic agent to reduce salivary, tracheobronchial and pharyngeal sections and to reduce the acidity of the gastric contents. • As a pre-operative or intra-operative antimuscarinic to attenuate or prevent intra-operative bradycardia with the use of suxamethonium or due to cardiac vagal reflexes. • To protect against the peripheral muscarinic actions of anticholinesterases such as neostigmine and pyridostigmine, used to reverse residual neuromuscular blockade produced by non- depolarising 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. Hyperhidrosis, Sialorrhea, Cerebral palsy.

Adult Dose

Parenteral Reduction of secretions Adult: Preoperative: 4 mcg/kg via IM admin 30-60 minutes before procedure. Intraoperative: 0.1 mg via IV admin, repeat at 2-3 minute intervals when needed. Max: 400 mcg/dose. Intravenous Reversal of neuromuscular blockade Adult: 200 mcg for each 1 mg of neostigmine or 5 mg of pyridostigmine. Alternatively, 5-15 mcg/kg with 50 mcg/kg neostigmine with 25-70 mcg/kg of neostigmine or 0.1-0.3 mg/kg of pyridostigmine. Peptic ulcer Adult: 0.1-0.2 mg 3-4 times daily via IM/IV admin.

Child Dose

Parenteral Reduction of secretions Child: Preoperative: IM admin: <2 yr: 4-9 mcg/kg; >2 yr: 4 mcg/kg, dose to be given 30-60 minutes before procedure. Intraoperative: IV admin: 4 mcg/kg (Max: 0.1 mg); repeat at 2-3-minute intervals as needed. Max Dosage: Child >1 mth: 200 mcg/dose. Intravenous Reversal of neuromuscular blockade Child: 10 mcg/kg with 50 mcg/kg neostigmine.

Contraindication

Angle-closure glaucoma; myasthenia gravis (large doses of quaternary ammonium compounds have been shown to block end plate nicotinic receptors); paralytic ileus; pyloric stenosis; prostatic enlargement. Anticholinesterase-antimuscarinic combinations such as neostigmine plus glycopyrronium should be avoided in patients with a prolonged QT interval.

Mode of Action

Glycopyrronium bromide is a quarternary ammonium antimuscarinic. It blocks acetylcholine at parasympathomimetic sites and induces smooth muscle relaxation. It also reduces gastric acid secretions and controls pharyngeal, tracheal and bronchial secretions. It antagonises muscarinic symptoms such as bronchorrhoea, bronchospasm, bradycardia and intestinal hypermotility induced by anticholinesterases.

Precaution

Antimuscarinics should be used with caution (due to increased risk of side effects) in Down’s syndrome, in children and in the elderly. They should also be used with caution in gastro-esophageal reflux disease, diarrhea, ulcerative colitis, acute myocardial infarction, hypertension, conditions characterized by tachycardia (including hyperthyroidism, cardiac insufficiency, cardiac surgery) because of the increase in heart rate produced by their administration, coronary artery disease and cardiac arrhythmias, pyrexia (due to inhibition of sweating), pregnancy and breast feeding. Because of prolongation of renal elimination, repeated or large doses of glycopyrronium bromide should be avoided in patients with uremia. Large doses of quaternary anticholinergic compounds have been shown to block end plate nicotinic receptors. This should be considered before using glycopyrrolate in patients with myasthenia gravis. It is known that the administration of anticholinergic agents during inhalation anesthesia can result in ventricular arrhythmias. Lactation: Excretion in milk unknown; use with caution

Side Effect

Anticholinergic symptoms (mydriasis, hyperthermia, tachycardia, cardiac arrhythmia),Dry mouth,Dry skin,Anhidrosis,Flushing,Blurred vision,Cycloplegia,Photophobia,Palpitation,Xerophthalmia,Constipation,Urinary retention Potentially Fatal: Severe anaphylaxis.

Interaction

Decreases levodopa effects. Effects may be enhanced by using drugs with antimuscarinic properties or MAOIs concurrently. May antagonise the GI effects of cisapride, metoclopramide and dompeidone. Potentially Fatal: IV admin in the presence of cyclopropane anesth can result in ventricular arrhythmias.