Glucagon

Aliases: GlucaGen, Gvoke 

Indications: Used to treat hypoglycemia in diabetics. It is also used as an antidote in beta-blocker and calcium blocker overdoses. Can be used for esophageal food impaction.

Contraindications:    Patients who have hypersensitivity reactions to glucagon, patients with pheochromocytoma, insulinomas, or glucagonomas. Of note, glucagon works by releasing glycogen stores, and will not improve hypoglycemia in patients with insufficient stores (starvation, adrenal insufficiency, chronic hypoglycemia).

Concentrations: 

Injection: 1 mg/mL reconstituted powder

Dosing

Adult:

Pediatric:

Indication	Dose	Route	Note
-Hypoglycemia	<20 kg= 0.5 mg ≥20kg= 1 mg	IV/IM	-May repeat once after 15 minutes
-Beta-Blocker/Calcium channel blocker Overdose	0.05mg/kg	IV/IM	-May repeat once after 15 minutes

Use Handtevy or Approved Pediatric Reference Guide for Amount to Administer

Precautions: Use with caution in patients with cardiac disease, chronic hypoglycemia (won’t raise glucose), pheochromocytoma (can trigger hypertensive crisis)

Adverse/Side Effects: Nausea and vomiting (common), headache, cough, sneezing, hypertension, tachycardia

Class: Anti-hypoglycemic 

Mechanism of Action: Promotes glycogenolysis and gluconeogenesis, causing a raise in glucose levels. Anti-hypoglycemic effect requires glucose stores.

In setting of beta-block and calcium channel blocker overdoses, the increased in cyclic AMP increases the automaticity at the SA and AV nodes. Increases muscle contractility.

Onset of Action	Peak Effect	Duration of Action
5 to 20 minutes (IV)  10 to 30 minutes (IM)	20 – 30 minutes	90 minutes (IM/IV)