Glucagon
Class:
Hyperglycemic agent, pancreatic hormone.
Hyperglycemic agent, pancreatic hormone.
Mechanism of Action:
- Increases blood glucose by stimulating glycolysis.
- Unknown mechanism of stabilizing cardiac rhythm in beta-blocker overdose.
- Minimal positive inotrope and chronotrope.
- Causes dilation of the esophagus and ideally will allow an obstruction to pass into the stomach.
Indications:
- Altered level of consciousness when hypoglycemia is suspected.
- May be used as inotropic agent in beta-blocker overdose.
- Medical Control: Patients with esophageal obstruction. Nancy's p: 1419.
Contraindications:
- Hyperglycemia.
- Hypersensitivity.
Adverse reactions:
- Nausea, vomiting.
- Tachycardia, hypertension.
Drug Interactions:
- Incompatible in solution with most other substances.
- No significant drug interactions with other emergency medications.
Adult Dosage and Administration
- Hypoglycemia: Administered when there is no IV/IO available for Dextrose administration:
1 mg IM/IN. Repeat in 15 minutes if glucose remains <70 mg/dl. (<4mmol/L) - Beta Blocker/Calcium Channel Blocker OD:
1-5mg IV/IO/IM titrated to effect. - Esophageal Obstruction: 1 mg IVP slow push.
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Pediatric Dosage and Administration:- Hypoglycemia: Administered when there is no IV/IO available for Dextrose administration:
0.1 mg/kg IM/IN/IV/IO (max dose 1 mg). Repeat in 15 minutes if glucose remains <70 mg/dl. (<4mmol/L) - Beta Blocker/Calcium Channel Blocker OD:
0.5 - 1.0 mg IV/IO/IM titrated to effect.
Duration of Action:
- Onset: 1 minute.
- Peak effect: 30 minutes.
- Duration: Variable (generally 9-17 minutes).
Special Considerations:
- Pregnancy safety: Category C.
- Ineffective if glycogen stores depleted.