Glucagon

Question 1

Generic Name:

Answer 1

Glucagon

Question 2

Class:

Answer 2

Pancreatic hormone, polypeptide, hyperglycemic agent

Question 3

Supplied:

Answer 3

1 mg vial of powder/1 mg vial of dilutent

Question 4

Mechanism of Action: Pharmacologic:

Answer 4

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.

Question 5

Mechanism of Action: Clinical:

Answer 5

May reverse hypoglycemia (if patient has glycogen stored in liver) within 4 to 8 minutes (could be as long as 15 or more).

Question 6

Indications and Field Use:

Answer 6

• Symptomatic hypoglycemia when IV access is delayed.

- Beta blocker poisoning

Question 7

Contraindications:

Answer 7

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

Question 8

Adverse Reactions:

Answer 8

• Rare side effects
• Nausea and vomiting
• Generalized allergic reactions inclding urticaria, respiratory distress and hypotension (made from beef/pork pancreas)
• Palpitations, hypertension, tachycardia

Question 9

Incompatibilities/Drug Interactions:

Answer 9

Unknown

Question 10

Adult Dosage: (children and adults greater than 20kg or 44lbs) Hypoglycemia:

Answer 10

1 mg IM, may repeat in 7 to 10 minutes

Question 11

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

Answer 11

0.5 mg IM or a dose equivalent to 20-30μg/kg, may repeat in 7-10 minutes

Question 12

Routes of Administration:

Answer 12

IM or SC administration avoids possibility of inducing encephalopathy in a thiamine-deficient patient

Question 13

Onset of Action: (dose and route dependent)

Answer 13

• 1 mg IM, 8 to 10 minutes

- 1 mg IV, 1 minute

Question 14

Peak Effects: (dose and route dependent)

Answer 14

• 1 mg IM, 12 to 14 minutes

- 1 mg IV, 3 to 6 minutes

Question 15

Duration of Action: (dose and route dependent)

Answer 15

• 1 mg IM, 12 to 27 minutes

- 1 mg IV, 20 minutes

Question 16

Arizona Drug Box Minimum Supply:

Answer 16

2 mg

Question 17

Special Notes:

Answer 17

•  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.