Glucagon
Glucagon
Glucagon Glucacon Diagnostic Kit Glucagon Emergency Kit (Rx)
( GLOO-kah-gon)
Pregnancy Category: B (Rx)

Classification: Insulin antagonist

Action/Kinetics: Produced by the alpha islet cells of the pancreas, glucacon accelerates liver glycogenolysis by stimulating synthesis of cyclic AMP and increasing phosphorylase kinase activity. Increased blood glucose levels result from increased breakdown of glycogen to glucose and inhibition of glycogen synthetase. Is effective only with sufficient liver glycogen. Glucagon stimulates hepatic gluconeogenesis by increasing the uptake of amino acids and converting them to glucose precursors. Also, lipolysis is increased, resulting in free fatty acids and glycerol for gluconeogenesis. Effective in overcoming hypoglycemia only if the liver has a glycogen reserve. Also relaxes smooth muscle of the GI tract and decreases gastric and pancreatic secretions; increases myocardial contractility. Glucagon for injection is of rDNA origin and is identical to human glucacon. Maximum plasma levels of glucagon: About 20 min following SC injection and about 13 min after IM injection. Peak glucose levels: 30 min after 1 mg glucagon SC and 26 min after 1 mg glucacon IM. Duration: 1-2 hr. t 1/2: 8-18 min. Metabolized in the liver, kidney, and plasma.

Uses: Treatment of severe hypoglycemia. Diagnostic aid in radiologic exams of the stomach, duodenum, small bowel, and colon where decreased intestinal motility is desired. Use only under medical supervision or in accordance with strict instructions received from the physician. Investigational: Treatment of propranolol overdose and in CV emergencies.

Contraindications: Use in pheochromocytoma.

Special Concerns: Use with caution during lactation, in clients with renal or hepatic disease, in those who are undernourished and emaciated, and in clients with a history of insulinoma. Safety and efficacy have not been determined for use in children as a diagnostic aid.

Side Effects: GI: N&V.; Allergy: Respiratory distress, urticaria, hypotension. Stevens-Johnson syndrome when used as diagnostic aid.

Overdose Management: Symptoms: N&V;, gastric hypotonicity, diarrhea, hypokalemia. Possible transient BP and pulse rate. Treatment: Symptomatic.

Drug Interactions: Anticoagulants, oral / Anticoagulant effects by hypoprothrombinemia Antidiabetic agents / Hyperglycemia due to glucagon antagonizes hypoglycemic drug effect Corticosteroids, Epinephrine, Estrogens, Phenytoin / Additive hyperglycemic effect of drugs listed

How Supplied: Powder for Injection: 1 mg (1 unit)

Dosage
?IM, IV, SC Severe hypoglycemia.
Adults and children > 20 kg: 1 mg (1 unit); if the response is delayed, give an additional dose of glucagon. Children < 20 kg: 0.5 mg (0.5 unit) or a dose equivalent to 20-30 mcg/kg.
Diagnostic aid for GI tract.
Dose dependent on desired onset of action and duration of effect necessary for the examination. IV: 0.25-0.5 mg (onset: 1 min; duration: 9-17 min); 2 mg (onset: 1 min; duration 22-25 min). IM: 1 mg (onset: 8-10 min; duration: 12-27 min); 2 mg (onset: 4-7 min; duration: 21-32 min). Because the stomach is less sensitive to glucagon, give 0.5 mg IV or 2 mg IM.
For colon examination.
IM: 2 mg 10 min prior to procedure.
Treatment of toxicity of beta-adrenergic blocking agents.
Adults, IV, initial: 2-3 mg given over 30 sec; may be repeated at the rate of 5 mg/hr until client is stabilized.