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[1] [2]

  • 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 [1] [2]

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

Special Populations[3]

  • 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

See Also

References

  1. ↑ 1.0 1.1 Kerns W. Management of beta-adrenergic blocker and calcium channel antagonist toxicity. Emerg Med Clin North Am. 2007;25(2):309-331. (Review)
  2. ↑ 2.0 2.1 Bailey B (2003). Glucagon in beta-blocker and calcium channel blocker overdoses: a systematic review. Journal of toxicology. Clinical toxicology, 41 (5), 595-602 PMID: 14514004
  3. ↑ Glucagon: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.
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