Glucagon

General

• Type: Hyperglycemic, antidote
• Dosage Forms:
• Common Trade Names: GlucaGen

Adult Dosing

Hypoglycemia

• 1mg SC/IM/IV x 1
• May repeat q20 min PRN

Beta-blocker toxicity

• 5mg IV bolus over one minute
• Rebolus if no response after 10min
• If effective, start infusion at 2-5mg/hr

Food bolus impaction

• 1mg IV x 1

Pediatric Dosing

Hypoglycemia

• 0.03mg/kg IM/SQ/IV x 1 (max = 1mg)
• Alternative
  • <20kg: 0.5mg SC/IM/IV x 1
  • >20kg: 1mg SC/IM/IV x 1
• May repeat q20 min

Beta-blocker toxicity

• 50mcg/kg
• Rebolus if no response after 10min
• If effective, start infusion at 70mcg/kg/hr

Special Populations

• Pregnancy Rating: B
• Lactation: Glucagon not absorbed in GI tract so unlikely to cause adverse reactions in infant
• Renal Dosing
  • Adult
    • Not defined
  • Pediatric
    • Not defined
• Hepatic Dosing
  • Adult
    • Not defined
  • Pediatric
    • Not defined

Contraindications

• Allergy to class/drug
• insulinoma
• pheochromocytoma

Adverse Reactions

Serious

• hypersensitivity reaction
• anaphylaxis
• hypotension

Common

• Nausea and vomiting
• hyperglycemia

Pharmacology

• Half-life: IV: 8-18 minutes IM: 45 minutes
• Metabolism: Liver, kidney
• Excretion: unknown
• Mechanism of Action: Stimulates hepatic glycogenolysis. GI smooth muscle relaxent

Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

	Indication	Dose	Context	Route	Population
Angioedema#Glucagon If on beta-blockers and not responding to epinephrine Adult	Angioedema	1-5 mg IV	If on beta-blockers and not responding to epinephrine	IV	Adult
Beta-blocker toxicity#Glucagon Positive inotrope/chronotrope (acts independently of beta receptors) Adult	Beta-blocker toxicity	5 mg IV bolus over 1 min (adult); 50 mcg/kg (pediatric); repeat in 10 min if no response; then drip 2-5 mg/hr	Positive inotrope/chronotrope (acts independently of beta receptors)	IV/IV drip	Adult
Beta-blocker toxicity#Glucagon Positive inotrope/chronotrope (pediatric) Pediatric	Beta-blocker toxicity	50 mcg/kg IV bolus; then 70 mcg/kg/hr drip	Positive inotrope/chronotrope (pediatric)	IV/IV drip	Pediatric
Calcium channel blocker toxicity#Glucagon Adjunct for bradycardia/hypotension Adult	Calcium channel blocker toxicity	5 mg IV bolus q10min x2	Adjunct for bradycardia/hypotension	IV	Adult
Hypoglycemia#Glucagon If unable to achieve IV access Adult	Hypoglycemia	1 mg SC or IM	If unable to achieve IV access	SC/IM	Adult
Neonatal hypoglycemia#Glucagon If no IV access or refractory hypoglycemia Pediatric	Neonatal hypoglycemia	0.03mg/kg IM/IV (max 1mg)	If no IV access or refractory hypoglycemia	IM/IV	Pediatric