Glucagon

Question 1

Classification

Glucagon

Answer 1

• Pancreatic hormone
• Insulin antagonist

Question 2

INDICATIONs

Glucagon

Answer 2

[PCP]
- confirmed or suspected hypoglycemia w/o IV access

[ACP]
- suspected β-blocker // Ca+ channel blocker OD

Question 3

CONTRAINDICATIONs

Glucagon

Answer 3

• hypersensitivity
• Pheochromocytoma

Question 4

Dosage - Adult

Glucagon

Answer 4

[PCP]
1mg IM/SC

Question 5

Dosage - Pediatric

Glucagon

Answer 5

[PCP]
< 25kg - 0.5mg IM/SC
- > 25kg - 1 mg IM/SC

Question 6

Pharmacodynamic

Glucagon

Answer 6

• accelerates the breakdown of glycogen (glycogenolysis) to glucose in the liver
• inhibits glycogen synthesis
  *only effective in treating hypoglycaemia if liver glycogen is available
• Exerts a positive inotropic action on the heart by increasing intracellular cAMP concentration via secondary messenger system (treatment of beta-blocker or Ca+ blocker OD)

Question 7

Pharmacokinetics

Glucagon

Answer 7

SC/IM
 Onset - 5-10mins
 Peak - 30-45mins
 Duration - 12-32mins

Question 8

Warnings // Precautions

Glucagon

Answer 8

• Hepatic or renal insufficiency
• Insulinoma - may stimulate further release of insullin and precipitate/worsen hypoglycaemia
• Pregnancy or lactation
• Pheochromocytoma - may cause release of catecholamines which may lead to significant HTN, tachycardia => ICH

Pheochromocytoma - adrenal gland cancer, ICH - intracerebral hemorrhage

Question 9

ADVERSE EFFECTs

Glucagon

Answer 9

• nausea or vomiting, hypokalemia, urticaria, resp. distress, hypotension
• transient increase in BP and HR

Question 10

OVERDOSE

Glucagon

Answer 10

• excessive parenteral admin => NVD
• oral ingestion unlikely

Question 11

DRUG INTERACTIONs

Glucagon

Answer 11

Hypoglycemia 2nd to ETOH+ consumption = unlikely reversible by Glucagon

Question 12

Supplied

Glucagon

Answer 12

kit w/ 1mg vial - to be reconstituted

supplied in powder form - use dilutent - NOT NaCl