Page 130 - 2026 SMOG

GLUCAGON
Class/Mechanism of Action
• Antidote, Hypoglycemia Antidote
Hyperglycemic agent, pancreatic hormone, insulin antagonist; raises blood glucose levels by stimulating
increased production of cyclic AMP, promoting hepatic glycogenolysis and gluconeogenesis.
Indications
• Labeled Indications
Management of hypoglycemia (Glucose <70)
• ˚ Off-Label Indications
Beta-blocker or calcium channel blocker-induced myocardial depression (with or without
˚ hypotension) unresponsive to standard measures.
˚ Hypoglycemia secondary to insulin or sulfonylurea overdose (as adjunct to dextrose)
Contraindications
• Hypersensitivity to glucagon or any component of the formulation
• Insulinoma/Pheochromocytoma
• Hyperglycemia
Adverse Reactions/Precautions
• Should NOT be used as 1st line medication for hypoglycemia or altered mental status
Hypoglycemic patients should receive dextrose. If IV access cannot be established or if dextrose is
˚ not available, glucagon may be used as an alternative until dextrose can be given.
• Nausea, vomiting, headache, upper respiratory system symptoms (cough, epistaxis, congestion, etc.),
hyperglycemia
• Pregnancy: Safe
• Lactation: Safe
Dose/Administration
PEDIATRIC
ADULT
(Always reference Broselow Tape)
Hypoglycemia Hypoglycemia
Note: Patients with inadequate glycogen stores Note: Patients with inadequate glycogen stores
(e.g., starvation, adrenal insufficiency, chronic (e.g., starvation, adrenal insufficiency, chronic
hypoglycemia) may not respond to glucagon and hypoglycemia) may not respond to glucagon and
should be treated with glucose should be treated with glucose
• IV/IM/SubQ • IV/IM/SubQ
˚ 1mg; may repeat in 15min prn Children <20kg: 0.5mg; if no response in
Beta-Blocker/Calcium Channel Blocker Overdose ˚ 15min, may repeat dose
Children ≥20kg: 1mg; if no response in
(Myocardial Depression) Unresponsive to Standard ˚ 15min, may repeat dose
Measures (Off-Label use)
• IV Beta-Blocker/Calcium Channel Blocker Overdose
2–10mg bolus; if no clinical response, may (Myocardial Depression) Unresponsive to Standard
˚ repeat bolus dose after 10–15min. If clinical Measures (Off-Label use)
response with bolus, start continuous infusion • IV (Infants and Children)
at 25mg/hr (range: 115mg/hr); titrate infusion Loading dose: 0.05mg/kg as a single dose; if
rate to achieve adequate hemodynamic ˚ no response, may repeat the dose
response Continuous IV infusion: 0.05–0.1mg/kg/hr;
˚ titrate to effect
• IV (Adolescents)
Loading dose: 5–10mg
˚ Continuous IV infusion: 1–5mg/hr; titrate to
˚ patient response
122 • MEDICATIONS