Glucagon Glucagen

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GENERIC NAME: GLUCAGON

BRAND NAME: Glucagon
CLASS: Pancreatic hormone, polypeptide, hyperglycemic

agent

Mechanism of Action:

Pharmacologic: Acts only on liver glycogen, converting it to glucose. Counteracts the effect of insulin. Relaxes GI smooth muscle causing dilation and decreased motility. Cardiac inotrope. Clinical effects: May reverse hypoglycemia (if patient has glycogen stored in liver) within 4-8 minutes (could be as long as 15 or more).

Indications and Field Use:

Symptomatic hypoglycemia when IV access is delayed. Beta Blocker Overdose

Contraindications:

Known
hypersensitivity Pheochromocytoma Insulinoma Should not be routinely used to replace dextrose when IV access has been obtained

Adverse Reactions:

Rare side effects Nausea and vomiting

Generalized allergic reactions including urticaria, respiratory distress and hypotension (made from beef/pork
pancreas) Palpitations, hypertension, tachycardia

NOTES ON ADMINISTRATION

Incompatibilities/Drug Interactions:

Unknown

Adult Dosage:

(children and adults greater than 20 kg or 44 lbs)

Hypoglycemia: 1 mg IM, may repeat in 20 minutes. IM preferred, but may give IM, IV or SC)

Pediatric Dosage:
(for children under 20 kg or 44 lbs) Hypoglycemia: 0.5 mg

IM or a dose equivalent to 20-30 μg/kg, may repeat in 20 minutes. IM preferred, but may give IM, IV or SC. Page 1 of 2

Routes of Administration:
Hypoglycemia: IM or SC administration avoids possibility

of inducing encephalopathy in a thiamine-deficient patient

Onset of Action:

(dose and route dependent) 1 mg IM, 8-10 minutes IV, 1 minute

Peak Effects:

(does and route dependent)
1 mg IM, 5-20 minutes IV, 5 – 20 minutes

Duration of Action:

(dose and route dependent) 1 mg IM, 12-27 minutes

IV, 20 minutes

Dosage Forms/Packaging:

1 mg (1 unit) with 1 mL vial of diluting solution 1 mg (1 unit) with prefilled syringe of diluting solution (Glucagon Emergency Kit)

Arizona Drug Box Supply:

PARAMEDIC: 2 mg

Special Notes:

> Blood sugar should be measured rapidly before deciding upon the administration of D50 or glucagon, especially in the non-diabetic patient.

> Documented hypoglycemia is a true medical emergency, IM glucagon should be administered rapidly if IV access is delayed.

> In known alcoholics, administer thiamine in addition to glucagon to prevent inducing an encephalopathy in a thiamine-deficient patient.

> Patients with Type I diabetes do not have as great a response in blood glucose levels as Type II stable patients. For all patients having hypoglycemic episode, supplementary complex carbohydrates should be eaten within 2 hour, especially in a child or adolescent. 

© Matt Dillard 2012