Glucagon

Question 1

What is the presentation?

Answer 1

1mg in 1ml vial, accompanied by diluent for injection.

Question 2

How does it work?

Answer 2

A hyperglycaemic agent that converts stored liver glycogen to glucose to increase blood glucose concentration.

Question 3

What is the onset and duration?

Answer 3

Onset: 4-7 minutes
Duration: 10-30 minutes.

Question 4

What are the indications?

Answer 4

For demonstrated hypoglycaemia where oral glucose cannot be administered and IV access cannot be obtained in a safe and timely manner.

Altered conscious state in a known diabetic or of otherwise unknown cause where blood glucose level is below 4mmol/L.

Question 5

What are the contraindications?

Answer 5

Hypersensitivity.

Known pheochromocytoma

Question 6

What are the precautions?

Answer 6

Glucagon is effective in treating hypoglycaemia only if sufficient liver glycogen is present (eg: it does not work on alcohol or anorexia induced hypoglycaemia).
Even if fully recovered, patients should be encouraged to be transported to a medical facility to ensure effective follow up and review.

Question 7

What is the adult dose?

Answer 7

Intramuscular injection into deltoid muscle or mid-lateral thigh

1mg in 1ml IM.
Repeat IM Glucagon after 10 minutes if unable to obtain IV access and patient still has inadequate GCS and blood glucose level.

Question 8

What is the paediatric dose?

Answer 8

Intramuscular injection into deltoid muscle or mid-lateral thigh

<5 years: 0.5mg in 0.5ml
6-12 years: 1.0mg in 1.0ml
Single dose only

Question 9

What are the side effects?

Answer 9

Nausea/vomiting
Gastric pain
Transient rise of blood pressure for patients taking beta blockers.