Glucagon

Question 1

What classifications is Glucagon under?

Answer 1

• Glucose elevating agent (pancreatic hormone)

- Insulin antagonist

Question 2

Explain the pharmacodynamics of Glucagon

Answer 2

• Accelerates the breakdown of glycogen (glycogenolysis) to glucose in the liver
• Elevates blood glucose levels by increasing the breakdown of glycogen to glucose and inhibiting glycogen synthesis
• Parenteral administration of glucagon produces relaxation of the smooth muscle of the stomach, duodenum, small bowel and colon
• Exerts a positive inotropic action on the heart by increasing intracellular cAMP concentration via the secondary messenger system (treatment of beta blocker or Ca++ channel blocker OD)
• Only effective in treating hypoglycemia if liver glycogen is available

Question 3

What is the onset timing for Glucagon?

Answer 3

8-10 minutes approx

Question 4

What is the peak timing for Glucagon?

Answer 4

20-30 minutes

Question 5

What is the duration for Glucagon?

Answer 5

19-32 minutes

Question 6

What is the half-life for Glucagon?

Answer 6

3-6 minutes

Question 7

List the precautions for Glucagon

Answer 7

• Hepatic or renal insufficiency
• Insulinoma – may stimulate further release of insulin and precipitate/worsen hypoglycemia
• Pregnancy or lactation

Question 8

List the adverse effects for Glucagon

Answer 8

• Nausea or vomiting, hypokalemia, urticaria, respiratory distress, hypotension
• Possible transient ­increase in blood pressure and increase in heart rate

Question 9

What is the ADULT dosing for Glucagon?

Answer 9

0.5 - 1 mg IM or SC (see medical directives for appropriate dose).

Question 10

Why would a Pheochromocytoma be a contraindication for Glucagon?

Answer 10

In patients with pheochromocytoma, glucagon may cause the tumor to release catecholamines which may lead to marked hypertension, tachycardia and intra-cerebral haemorrhage

Question 11

How does Glucagon treat β (Beta) blocker ODs?

Answer 11

Sometimes used IV in high dose as a +ve inotropic agent in the treatment of β (Beta) blocker OD - it increases heart and force of contractility through non-adrenergic pathways

Question 12

Can a Glucagon tablet be reconstituted with normal saline?

Answer 12

Must not be reconstituted with normal saline, as it will not dissolve - Must be reconstituted with glycerine (provided with glucagon kit, in a single-use syringe.