Glucagon

Question 1

class

Answer 1

pancreatic hormone, polypeptide, hyperglycemic agent

Question 2

mechanism of action

Answer 2

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).

Question 3

indications and field use

Answer 3

Symptomatic hypoglycemia when IV access is delayed.

Beta blocker poisoning

Question 4

contraindications

Answer 4

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

Question 5

adverse reactions

Answer 5

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

Question 6

incompatibilities/drug reactions

Answer 6

unknown

Question 7

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

Answer 7

Hypoglycemia: 1 mg IM, may repeat in 7-10 minutes

Question 8

peds dose ( for children under 20 kg or 44 lbs)

Answer 8

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

Question 9

routes of administration

Answer 9

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

Question 10

onset of action

Answer 10

1 mg IM, 8-10 minutes

IV, 1 minute

Question 11

peak effects

Answer 11

1 mg IM, 12-14 minutes

IV, 3-6 minutes

Question 12

duration of action

Answer 12

1 mg IM, 12-27 minutes

IV, 20 minutes

Question 13

AZ drug box minimum

Answer 13

2 mg

Question 14

special notes

Answer 14

 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.