Description and indication for use
Glucagon is a pancreatic hormone. Glucagon stimulates cyclic AMP in the liver
and adipose tissue, initiating gluconeogenesis and glycogenolysis, resulting in
an increase in blood sugar. Parenteral
administration produces relaxation of the smooth muscle of the gastrointestinal
tract and bronchial tree. Glucagon
increases the force of contraction of the heart, with little or no effect on
heart rate.
Glucagon is effective in the treatment of
hypoglycaemia due to severe insulin reactions and hypoglycaemia when glucose
infusion is unavailable or there is no response to routine treatment.
The onset of action of Glucagon is 5 to 20
minutes, the half-life being only 3 to 6 minutes, with duration of action
usually 1 to 2 hours. Glucagon is
inactivated mainly in the liver and kidney.
Dose
1 unit = 1 mg.
IV, IM and SC:
300 micrograms/kg/dose (0.3 mg/kg/dose) may
be repeated in 20 minutes if necessary.
(Maximum
dose = 1 mg)
IV infusion:
5 to 10 micrograms/kg/hour.
Reconstitution/Dilution
Vial = 1 unit (1 mg). Glucagon should only be reconstituted using
the diluting solution provided = 1 mL of
reconstituted solution = 1 mg/mL
IV, IM and SC:
Use 1 mg/mL solution.
IV infusion:
Withdraw prescribed amount of Glucagon and
make up to ordered volume with Glucose 10%.
Once diluted in Glucose, the solution is
stable for 8 hours only.
|
DRUG
|
HOW TO MAKE UP
|
DOSE EQUIVALENT
|
DOSE RANGE
|
|
Glucagon
|
250
microgram/kg in 25 mL Glucose 10%
|
1 mL/hr
= 10 microgram/kg/hr
|
5
to 10 microgram/kg/hr
|
Route and method of administration
IV, IM and SC:
STAT using 1 mg/mL solution.
More than 1 IM site may be required if
maximum dose is to be given.
IV infusion:
Infuse at prescribed rate via syringe pump.
Side effects
Nausea, vomiting.
Tachycardia.
Rebound hypoglycaemia.
Contraindications
Hypersensitivity to protein compounds.
Patients who have decreased Glycogen stores
(Do not use in IUGR/SGA).
Patients with Insulinoma.
Incompatibilities
Administer alone.
Drug interactions
No known interactions.
Nursing responsibilities
Obtain blood glucose levels as condition
indicates.
Monitor clinical status continuously.
Avoid giving boluses when giving infusion.
Infusion:
Check that rate ordered corresponds with appropriate dose required
(mcg/kg/hr).