Drug Summary

Glucagon

Pharmacologic properties:

Glucagon is an endogenous hormone that is produced in the pancreas. It acts as an insulin antagonist, accelerating hepatic glycogenolysis and gluconeogenesis. This has the effect of increasing blood glucose concentrations. Glucagon also effectively restores force and rate of ventricular contractions in patients with symptomatic beta-blocker and calcium channel blocker overdose via stimulation of intracellular cyclic adenosine monophosphate (cAMP) production.

Indications:

  • Hypoglycemia (where IV access cannot be obtained).
  • Beta-blocker and calcium channel blocker overdoses.

Contraindications:

  • Known hypersensitivity

Precautions:

  • Glucagon should be administered with caution in patients with a history of insulinoma or pheochromocytoma
  • Awaken patient following administration to provide oral glucose in order to replete glycogen stores

Adverse Reactions:

  • Occasional nausea and vomiting

Dosage and administration:

  • Adult
    • Hypoglycemia
      • 1 mg IM
    • Beta-blocker or calcium channel blocker overdose
      • 5.0 mg IV bolus
  • Pediatric
    • Hypoglycemia
      • 0.1 mg/kg IM (maximum dose 1 mg)
    • Beta-blocker or calcium channel blocker overdose
      • 0.5 mg IV/IM if < 20 kg
      • 1 mg IV/IM if ≥ 20 kg