GLUCAGON

CLASS:

• Pancreatic hormone

• Insulin antagonist / Antihypoglycemic

ACTION:

• Converts liver glycogen to glucose to raise blood sugar level, and inhibits glycogen synthesis

• Stimulates glucagon receptors in cardiac cells (in larger doses) and may be of benefit in beta blocker overdoses by increasing the force of contraction ( + inotropic) and rate of contraction ( + chronotropic) by stimulating the production of cyclic adenosine monophosphate (cAMP), which results in increased plasma glucose concentration, smooth muscle relaxation, and an inotropic myocardial effect.

INDICATIONS:

• Hypoglycemia if no IV route available

• Beta blocker overdose with profound bradycardia

• May be effective in some calcium channel blocker overdoses

CONTRAINDICATIONS:

• Hypersensitivity

STANDARD PREP:

• 1 mg powder with 1 cc diluent

DOSAGE/ROUTE:

• See Hawai’i S.O.

PEDIATRIC DOSE:

• See Hawai’i S.O.

SIDE EFFECTS:

• Nausea & Vomiting

PRECAUTION:

• Should not be used as a first line drug for hypoglycemia

• Will be ineffective in conditions where glycogen stores are depleted, ie. chronic hypoglycemia, starvation

*Glucagon is thought to activate myocardial adenyl cyclase by a mechanism independent of B-receptor stimulation. Adenyl cyclase generates cAMP which causes positive inotropic and chronotropic effects.