MTW NHS Trust West Kent CCG

Drug Status Key

  • Preferred
  • Second Line
  • Third Line
  • Specialist Initiation
  • Hospital Only
  • Not Approved for Formulary


Important safety information

Antimuscarinic drugs used for premedication to general anaesthesia should only be administered by, or under the direct supervision of, personnel experienced in their use.


Please see drug specific guideline below

Atropine sulfate is now rarely used for premedication but still has an emergency role in the treatment of vagotonic side effects and is also used to treat acute arrhythmias after myocardial infarction.

Hyoscine hydrobromide reduces secretions and also provides a degree of amnesia, sedation and anti-emesis. Unlike atropine it may produce bradycardia rather than tachycardia. In some patients, especially the elderly, hyoscine may cause the central anticholinergic syndrome.

Glycopyrronium bromide reduces salivary secretions. When given intravenously it produces less tachycardia than atropine. It is widely used with neostigmine for reversal of non-depolarising neuromuscular blocking drugs.