Page 143 - 2023 SMOG Digital

GLUCAGON B Lactation? (Caution)
Class / Mechanism of Action
Antidote, Hypoglycemia Antidote, Diagnostic agent
Raises blood glucose levels by stimulating increased production of cyclic AMP, promoting hepatic
glycogenolysis and gluconeogenesis
Indications
Labeled Indications: Management of hypoglycemia (Glucose <70 in adults or <60 in children)
Unlabeled:
• 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
Adverse Reactions / Precautions
• Should NOT be used as 1 st line medication for hypoglycemia or Altered mental status
o Hypoglycemia patients should receive dextrose. If IV access cannot be established or if
dextrose is not available, glucagon may be used as alternate until dextrose can be given.
• Thiamine should precede use in patient with suspected alcoholism or malnutrition
Dose and Administration: ADULT PEDIATRIC Always Reference BROSELOW Tape
Hypoglycemia: *Hypoglycemia:
IV, IM, SubQ: IV, IM, SubQ:
• 1mg; may repeat in 20 minutes prn • Children <20kg: 0.5mg or 20-30mcg/kg/dose;
repeated in 20 prn.
• Children ≥20 kg: Adult dosing.
Beta-blocker / Calcium channel blocker
overdose (myocardial depression) unresponsive Note: IV dextrose should be given ASAP; if patient
to standard measures (unlabeled use): fails to respond to glucagon, IV dextrose must be
IV: (ACLS, 2015) given
• 3-10mg (or 0.05-0.15mg/kg) bolus followed by *Only use if hyperinsulinemia thought to be
an infusion of 3-5mg/hour (or 0.05-0.1mg/kg/hr); cause of hypoglycemia (rare in kids). If
titrate infusion rate to achieve adequate hypoglycemic without glycogen stores,
hemodynamic response Glucagon will be ineffective.

Beta-blocker / Calcium channel blocker
overdose (myocardial depression) unresponsive
to standard measures (unlabeled use):
IV:
• 30-150mcg/kg bolus. Can be repeated if no
response in 15 min. Follow with an infusion of
20-70mcg/kg/hr; titrate infusion rate to achieve
adequate hemodynamic response

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