Glucagon

Trade Names: Glucagen, Glucagon

Class: Pancreatic hormone, anti-hypoglycemic agent

Pharmacology:

Onset: within 1 min
Duration: 60-90 min

Results in blood glucose elevation by increasing the breakdown of glycogen to glucose and stimulating glucose synthesis. Causes positive inotropic effect on the heart and decreases renal vascular resistance

Indications: Hypoglycemia, Calcium channel blocker or beta-blocker toxicity
Contraindications: Hypersensitivity (allergy to proteins)
Cautions: Effect of anticoagulants may be increased if given with glucagon

Do not mix with saline

Packaging: Must be reconstituted prior to administration. Dilute 1 mg of white powder in 1 mL of diluting solution (1 mg/mL)

Dosage:
Hypoglycemia:
  • Adult – 0.5-1 mg IM may repeat in 7-10 min
  • Pediatric – for >20 kg, 0.5-1mg IM

Calcium Channel Blocker or Beta-Blocker Toxicity:

  • Adult – 3-10 mg slow IV over 3-5 min, followed by infusion at 3-5 mg/hr

Side Effect

  • Tachycardia
  • Hypotension
  • Nausea and vomiting
  • Urticaria
Special Considerations:

Pregnancy safety: category B
Glucagon should not be considered a first line for hypoglycemia
May cause vomiting and hyperglycemia
IV glucose will need to be administered if patient doesn’t respond to a second dose of glucagon
Do not use the provided diluent to mix continuous infusions