Glucagon is a peptide hormone secreted by the pancreas that raises blood glucose levels. Its has the opposite effect of insulin. The pancreas releases glucagon when blood glucose levels fall too low. Glucagon causes the liver to convert stored glycogen into glucose, which is released into the bloodstream.

Glucagon can be used for treatment of:

  1. Hypoglycemia. Useful for severe hypoglycemia when the victim is unconscious or for other reasons cannot take glucose orally. The dose for an adult is typically 1 milligram, and the glucagon is given by intramuscular, intravenous or subcutaneous injection, and quickly raises blood glucose levels.
  2. Beta-blocker overdose. Glucagon increases cAMP in the myocardium, in effect bypassing the β-adrenergic second messenger system.
  3. Calcium channel blocker overdose.
  4. Impacted food bolus. Glucagon relaxes the lower esophageal sphincter and is used in emergencies involving an impacted food bolus in the esophagus.

The onset of action of glucagon is within 5 minutes and the duration of action is 15 minutes. Side effects can include nausea and vomiting.

Glucagon Emergency Kit is an an injectable form of glucagon available for first aid cases.

Glucagon Emergency Kit

 

Dosing

  • For adults and for pediatric patients weighing more than 44 lb (20 kg), give 1 mg (1 unit) by subcutaneous, intramuscular, or intravenous injection.
  • For pediatric patients weighing less than 44 lb (20 kg), give 0.5 mg (0.5 unit) or a dose equivalent to 20 to 30 µg/kg.2-6.

General Notes

  • Glucagon was originally prepared from purified porcine pancreas, but the preparation that is now in common use is manufactured by rDNA synthesis.
  • The diluent (Hyporet) is provided for use only in the preparation of glucagon for parenteral injection and for no other use.
  • Glucagon should not be used at concentrations greater than 1 mg/mL (1 unit/mL).
  • Glucagon is highly unstable when dissolved in solution. When dissolved in a fluid state, glucagon can form amyloid fibrils, or tightly woven chains of proteins made up of the individual glucagon peptides, and once glucagon begins to fibrilize, it becomes useless when injected, as the glucagon cannot be absorbed and used by the body.
  • Stability and Storage:

    • Before Reconstitution— Vials of Glucagon, as well as the Diluting Solution for Glucagon, may be stored at controlled room temperature 20° to 25°C (68° to 77°F).
    • After Reconstitution— Glucagon for Injection (rDNA origin) should be used immediately. Discard any unused portion.

Preparation

Step 1.

When you open the case you will find a vial of glucagon and a prefilled syringe of diluent. There are instructions on the inside top of the case that is useful as a reminder, but it is important that you familiarize yourself with the preparation steps before you need it in an emergency.