Name

glucagon

Class

Pancreatic hormone, insulin antagonist

Description/Mechanism

Glucagon is a protein secreted by the alpha cells of the pancreas. When released, it results in blood glucose elevation by increasing the breakdown of glycogen to glucose and inhibiting glycogen synthesis. The drug is only effective in treating hypoglycemia when the patient has adequate stored glycogen.

In addition, glucagon exerts positive inotropic action on the heart and decreases renal vascular resistance. It is, therefore, also used in managing patients with beta-blocker cardiotoxicity.

Onset

Within 1 minute

Duration

9-17 minutes

Indications

Hypoglycemia with altered level of consciousness

Beta-blocker overdose.

Contraindications

Hypersensitivity

Adverse Reactions

Tachycardia

Hypertension

Nausea and vomiting

Drug Interactions

None significant

Supplied

Glucagon must be reconstituted (with provided solution) before administration. Dilute 1 unit (1mg) white powder in 1ml of diluting solution (1mg/ml)

Dose/Administration

Hypoglycemia

Adult

1 mg IM, may repeat in 10 minutes.

Pediatric

0.5 mg IM, may repeat in 10 minutes.

Beta-blocker Toxicity

Adult

1-5 mg slow IV (over 2 - 5 minutes)

Pediatric

0.0015 - .1 mg/kg slow IV

Special Consideration

Pregnancy Safety: Category B

Should not be considered a first-line choice for hypoglycemia. Useful primarily in situations where an IV can not be established for the administration of 50% dextrose.

IV glucose will need to be administered if the patient does not respond to a second dose of glucagon