Glucagon

Provider Level

AEMT/RN/Paramedic

Class

Pancreatic hormone, antihypoglycemic agent, antidote.

Mechanism of Action

Stimulates hepatic glycogenolysis and gluconeogenesis to increase blood glucose levels. Also produces positive inotropic and chronotropic cardiovascular effects independent of beta-adrenergic receptors.

Indications

Severe hypoglycemia when intravenous access cannot be established. Antidote for beta-blocker or calcium channel blocker toxicity.

Contraindications

Hypersensitivity to the drug, pheochromocytoma, insulinoma.

Routes

IM, SQ, IV, IO

Onset / Duration

Onset: 1 minute (IV), 5-20 minutes (IM/SQ). Duration: 60-90 minutes.

Adverse Effects

Nausea, vomiting, tachycardia, hypertension, rebound hypoglycemia.

Precautions & Interactions

Ineffective in patients with depleted hepatic glycogen stores such as those with malnutrition, chronic alcoholism, or prolonged hypoglycemia. High incidence of vomiting; position patient to protect the airway.

Special Considerations

Must be reconstituted with provided diluent immediately prior to administration. Administer supplemental carbohydrates as soon as the patient is awake and able to swallow to replenish glycogen stores.