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
- Adult
- Hepatic Dosing
- Adult
- Not defined
- Pediatric
- Not defined
- Adult
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 | 1-5 mg IV | If on beta-blockers and not responding to epinephrine | IV | 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 | 50 mcg/kg IV bolus; then 70 mcg/kg/hr drip | Positive inotrope/chronotrope (pediatric) | IV/IV drip | Pediatric |
| Calcium channel blocker toxicity | 5 mg IV bolus q10min x2 | Adjunct for bradycardia/hypotension | IV | Adult |
| Hypoglycemia | 1 mg SC or IM | If unable to achieve IV access | SC/IM | Adult |
| Neonatal hypoglycemia | 0.03mg/kg IM/IV (max 1mg) | If no IV access or refractory hypoglycemia | IM/IV | Pediatric |
See Also
References
- ↑ 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)
- ↑ 2.0 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
- ↑ Glucagon: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.