Miscellaneous neurodegenerative disorders:
Indications for CUVPOSA:
To reduce chronic severe drooling in patients 3–16yrs of age with neurologic conditions associated with problem drooling (eg, cerebral palsy).
<3yrs: not recommended. Use accurate measuring device. Take on empty stomach. 3–16yrs: initially 0.02mg/kg 3 times daily; may titrate in increments of 0.02mg/kg every 5–7 days based on response and adverse reactions. Max 0.1mg/kg 3 times daily, not to exceed 1.5–3mg per dose based upon weight. See literature.
Conditions that preclude anticholinergic therapy (eg, glaucoma, paralytic ileus, unstable cardiovascular status in acute hemorrhage, severe ulcerative colitis, toxic megacolon, myasthenia gravis). Concomitant potassium chloride solid oral dosage forms (passage through GI may be arrested or delayed).
Monitor for constipation esp. within 4–5 days of initial dosing or after dose increase. Discontinue if incomplete mechanical intestinal obstruction develops (diarrhea may be early symptom). Autonomic neuropathy. Renal impairment. Ulcerative colitis (esp. large doses). Hyperthyroidism. Cardiovascular disease. CHF. Arrhythmias. Tachycardia. Hypertension. Hiatal hernia associated with reflux esophagitis. Avoid high environmental temperature. Pregnancy (Cat.C). Nursing mothers.
See Contraindications. May potentiate digoxin slow dissolution oral tabs; monitor and consider using other forms (eg, elixir, caps). Additive antichlolinergic effects with amantadine; consider reducing glycopyrrolate dose. May potentiate atenolol, metformin; consider dose reduction. May antagonize haloperidol (closely monitor or avoid), levodopa (consider increasing dose).
Dry mouth, vomiting, constipation, flushing, nasal congestion; drowsiness, blurred vision, intestinal pseudo-obstruction, mechanical intestinal obstruction.