Glucagon

Question 1

Drug code for Glucagon?

Answer 1

GLU

Question 2

Presentation of Glucagon?

Answer 2

Glucagon injection, 1 milligram of powder in vial for reconstitution with water for injection

Question 3

Indications for use of Glucagon?

Answer 3

Hypoglycaemia, clinically suspected hypoglycaemia or unconscious patients where hypoglycaemia a likely cause (blood glucose < 4.0 millimoles (mmol/L) per litre)

Question 4

In what cases would Glucagon be administered as a second resort?

Answer 4

When oral glucose administration is not possible or is ineffective and/or when IV access to administer 10% glucose is not possible

Question 5

Actions of Glucagon?

Answer 5

Glucagon is a hormone that induces the conversion of glycogen to glucose in the liver, thereby raising blood glucose levels

Question 6

Contra-indications of Glucagon?

Answer 6

Pheochromocytoma

Glucagon should not be given by IV injection because of increase vomiting associated with IV use

Question 7

What is Pheochromocytoma?

Answer 7

a rare tumor of adrenal gland tissue. It results in the release of too much epinephrine and norepinephrine, hormones that control heart rate, metabolism, and blood pressure.

Question 8

Cautions for use of Glucagon?

Answer 8

Low glycogen stores e.g. recent use of Glucagon or starvation
For hypoglycaemic seizures, glucose 10% IV is the preferred intervention

Question 9

Side effects of Glucagon?

Answer 9

Nausea, vomiting
Abdominal pain in adults
Diarrhoea in children
Hypokalaemia
Hypotension in adults
Acute hypersensitivity reaction, although this is rare

Question 10

What is Hypokalaemia?

Answer 10

a low level of potassium (K+) in the blood serum.

Question 11

What is meant by the term blood serum?

Answer 11

The fluid and solute component of blood which does not play a role in clotting.
It may be defined as blood plasma without fibrinogens.

Question 12

What can be found in blood serum?

Answer 12

all proteins not used in blood clotting; all electrolytes, antibodies, antigens, hormones; and any exogenous substances.

Question 13

How many times can Glucagon be administered?

Answer 13

Once

Check whether Glucagon has already been administered by a relative/carer

Question 14

How would you confirm effectiveness of Glucagon?

Answer 14

Checking blood glucose levels 10-15 minutes after administration

Question 15

When might Glucagon be ineffective?

Answer 15

In the very young, old people, undernourished patients or those with haptic disease
Glucagon is relatively ineffective once body glycogen stores have been exhausted, especially in hypoglycaemic, non-diabetic children
Alcohol-induced hypoglycaemia

Question 16

If a hypoglycaemic patient is convulsing what is the course of treatment?

Answer 16

If the patient is conscious, use glucose 40% gel as a first line treatment
Unconscious patients will require glucose 10% IV

Question 17

Why is Glucagon ineffective in new born baby’s?

Answer 17

Their liver has very limited glycogen stores, so hypoglycaemia may not be effectively treated using IM Glucagon

Question 18

How does Glucagon work?

Answer 18

Stimulates the liver to convert glycogen into glucose

Question 19

Where should Glucagon be administered?

Answer 19

Intramuscular, anterograde-lateral aspect of thigh or upper arm

Question 20

Initial dose of Glucagon?

Answer 20

1 milligram

Question 21

Can a repeat dose of Glucagon be given?

Answer 21

No

Question 22

What is the dose interval for Glucagon?

Answer 22

N/A

Question 23

Volume of Glucagon?

Answer 23

1 vial

Question 24

Maximum dose of Glucagon that can be given?

Answer 24

1 milligram

Question 25

Age at which a standard dose of Glucagon can be given?

Answer 25

Adults, age 12 or older

1 milligram per vial