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Class
Hyperglycemic agent, Pacreatic hormone, insulin antagonist.
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Mechanism of Action
Increases blood glucose level by stimulating glycogenesis. Unknown mechanism of stabilizing cardiac rhythm in beta blocker overdose. Minimal positive inotropic and chronotropic response. Decreases gastrointestinal motility and secretions.
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Indications
Altered level of consciousness when hypoglycemia is suspected. May be used as inotropic agent in beta blocker overdose.
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Contraindications
Hyperglycemia, hypersensitivity.
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Adverse reactions
Nausea, vomiting, tachycardia, hypertension.
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Drug interactions
Incompatible in solution with most other substances. No significant drug interactions with other emergency medications.
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How supplied
1-mg ampules (requires reconstitution with diluent provided)
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Dosage and administration
- Adult: Hypoglycemia: 0.5-1 mg IM; may repeat in 7-10 minutes. Calcium channel blocker or beta blocker overdose: 3 mg initially, followed by infusion at 3 mg/hr as necessary.
- Pediatric: Hypoglycemia: 0.5-1 mg IM (for children < 20 kg). Calcium channel blocker or beta blocker overdose: not recommended.
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Duration of action
- Onset: 1 minute.
- Peak effect: 30 minutes.
- Duration: variable (generally 9-17 minutes).
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Special Considerations
Pregnancy safety: Category C. Ineffective if glycogen stores depleted. Should always be used in conjunction with 50% dextrose whenever possible. If patient does not respond to second dose glucagon, 50% dextrose must be administered.
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