Glucagon

Glucagon Brand Names

baqsimi | GlucaGen | Glucagon | Gvoke

What is Glucagon

Recombinant glucagon is identical to native glucagon. The recombinant injection products are expressed in either a Saccharoyces cervisiae (e.g., GlucaGen) or Escherichia coli strain (e.g., Glucagon, Lilly), with subsequent purification.

Glucagon nasal powder (Baqsimi) and glucagon injection (Gvoke) are also identical to native glucagon.

Native human glucagon is a hormone synthesized by the alpha-2 cells of the pancreatic islets of Langerhans and acts to increase blood glucose. Glucagon is used in the emergency treatment of severe hypoglycemia in patients with diabetes mellitus.

Other uses for glucagon are as a diagnostic aid in radiologic and endoscopic examination of the gastrointestinal (GI) tract; it is approved in adults for this purpose and is used off-label in pediatric patients for diagnostic use.

It is also used as a second-line agent as a cardiac stimulant in beta-adrenergic blocker overdose to help treat bradycardia; high dose infusions have been necessary for adjunctive treatment of these cases.

While also used for calcium channel blocker overdose in some studies, the evidence is lacking for a survival benefit with its use

Indications

  1. beta-blocker toxicity
  2. choking due to esophageal foreign body impaction
  3. congenital hyperinsulinemia
  4. hypoglycemia
  5. magnetic resonance imaging (MRI)
  6. radiographic examination
  7. verapamil toxicity

For the treatment of severe hypoglycemia

patients with diabetes mellitus

Side Effects

  1. abdominal pain
  2. anaphylactic shock
  3. anaphylactoid reactions
  4. antibody formation
  5. bullous rash
  6. chest pain (unspecified)
  7. coma
  8. cough
  9. dysgeusia
  10. epistaxis
  11. headache
  12. hyperglycemia
  13. hypertension
  14. hypoglycemia
  15. hypotension
  16. injection site reaction
  17. nasal congestion
  18. nausea
  19. necrolytic migratory erythema
  20. parosmia
  21. pruritus
  22. rash
  23. rhinorrhea
  24. sinus tachycardia
  25. sneezing
  26. throat irritation
  27. urticaria
  28. vomiting

Monitoring Parameters

  • blood glucose

Contraindications

  • adrenal insufficiency
  • anorexia nervosa
  • breast-feeding
  • cardiac disease
  • coronary artery disease
  • driving or operating machinery
  • infants
  • insulinoma
  • malnutrition
  • pheochromocytoma
  • pregnancy

Interactions

  • Anticholinergics
  • Atropine
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benztropine
  • Beta-blockers
  • Chlordiazepoxide; Clidinium
  • Dicyclomine
  • Flavoxate
  • Glycopyrrolate
  • Glycopyrrolate; Formoterol
  • Homatropine; Hydrocodone
  • Hyoscyamine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Indacaterol; Glycopyrrolate
  • Indomethacin
  • Insulins
  • Mepenzolate
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methscopolamine
  • Oxybutynin
  • Propantheline
  • Scopolamine
  • Trihexyphenidyl
  • Warfarin
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