Daily Bolus of LR: The many uses of Glucagon!

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June 29, 2011 by dailybolusoflr

The many uses of GLUCAGON

Glucagon is FDA approved for the treatment of hypoglycemia.

* When IV cannot be obtained to administer dextrose or the patient is unable to eat, you can use IM/SC glucagon to release glycogen stores in the form of glucose.
* Note: In patients who lack glycogen stores (malnourished patients such as alcohol dependent patients), glucagon will not be effective.
* 0.5mg -1mg can be administered IV/IM/SC

Glucagon is used off-label for two other common treatments:

Beta blocker (also considered for calcium-channel blocker) overdose

* Glucagon has both inotropic and chronotropic effects at higher doses (increase in cAMP in myocardium)
* Can be administed 5-10mg IV and then as a drip at 2-5mg/hour
* The half life is around 20 minutes
* Especially in situations such as anaphylaxis where patients are on beta blockers, glucagon should be considered so that patients have more physiologic compensatory mechanisms

Esophageal food impaction

* Glucagon relaxes smooth muscle and can be used for food impaction in the lower esophagus to relax the lower esophageal sphincter
* 1mg can be administered IV
* Side effects are most commonly nausea and vomiting, flushing

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