Made by the alpha cells of the pancreas, glucagon increases the amount of circulating glucose readily available for use (refer to Picmonic "Pancreas"). Glycogen is a form of glucose stored in the liver that converts to glucose when necessary. Glucagon promotes glycogenolysis or the hepatic conversion of stored glycogen into glucose to be released into the bloodstream. This drug also inhibits glycolysis or the conversion of glucose to stored glycogen. Glucagon increases the biosynthesis of readily-available glucose.
Insulin overdose causes a significant decrease in glucose and results in emergent hypoglycemia (Refer to Picmonic "Hypoglycemia Assessment"). Emergent hypoglycemia should be treated immediately to prevent irreversible brain damage, coma, and ultimately death. Glucagon is not indicated for patients with hypoglycemia related to starvation due to the lack of glycogen stores.
Nausea and vomiting are common side effects related to the sudden increase in blood sugar levels. Administer glucagon slowly to minimize the risk of nausea and vomiting. If the patient is unconscious, turn the patient on the side to prevent aspiration.
This powder medication must be immediately reconstituted with a sterile diluent provided by the manufacturer prior to use. The reconstituted solution is a concentration of 1 mg/mL or less and a dose of 0.5-1.0 mg is typically administered IM, SQ, or IV.
Since glucagon is metabolized within an hour, the patient's blood sugar will rapidly drop and experience rebound hypoglycemia. If the patient is conscious and able to swallow, administer oral carbohydrates to replenished glycogen stores in the liver.
If glucagon fails to improve the patient's condition, IV 50% glucose may be given to immediately to raise the patient's plasma glucose levels. The patient usually regains consciousness within 20 minutes of IV 50% glucose.
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