Question

Search for Glucagon information: Generic Name, Brand Name, Type of drug, Pregnancy Category, Therapeutic action, . Indications, Contraindications,. Dose / Adult and Pediatric, Adverse effects, Interactions, Nursing considerations in implementation and Patient Education

Answer 1

Ans-glucagon generic name is GlucaGen, Gvoke (glucagon)

Glucagon is available under the following different brand names: Glucagen, Glucagon Emergency Kit, and GlucaGen HypoKit.

Type of drug-Glucagon is a medication and hormone.

Pregnancy category- pregnant women over decades of use have not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes; multiple small studies have demonstrated a lack of transfer of pancreatic glucagon across human placental barrier during early gestation

Therapeutic action-

Glucagon binds to the glucagon receptor activating Gsα and Gq .This activation activates adenylate cyclase, which increases intracellular cyclic AMP and activates protein kinase A. Activating Gq activates phospholipase C, increases production of inositol 1,4,5-triphosphate, and releases intracellular calcium. Protein kinase A phosphorylates glycogen phosphorylase kinase, which phosphorylates glycogen phosphorylase, which phosphorylates glycogen, causing its breakdown.

Glucagon also relaxes smooth muscle of the stomach, duodenum, small bowel, and colon

Indication-Hypoglycemia ,Use glucagon to treat insulin coma or insulin reaction resulting from severe hypoglycemia (very low blood sugar). Symptoms of severe hypoglycemia include disorientation, unconsciousness, and seizures or convulsions,

hormone testing

Contraindications-hypersensitivity to it ,known case of pheochromocytoma

Dose =

Adult-

Usual Adult Dose for Diagnostic

For relaxation of the stomach, duodenal bulb, duodenum, and small bowel:
IV: 0.2 mg to 0.5 mg IV prior to procedure
IM: 1 mg IM prior to procedure

For relaxation of the colon:
IV: 0.5 mg to 0.75 mg IV prior to procedure
IM: 1 mg to 2 mg IM prior to procedure

Usual Adult Dose for Hypoglycemia

Glucagon Emergency Kit and GlucaGen HypoKit: 1 mg IM/IV or subcutaneously once
GVOKE Auto-Injector and Prefilled Syringes: 1 mg subcutaneously once

REPEAT DOSE: An unconscious patient will usually awaken within 15 minutes following treatment; if response is delayed, may repeat dose while waiting for emergency assistance

Nasal:
1 actuation (3 mg) into 1 nostril once
-If there is no response after 15 minutes, may administer an additional 3 mg dose from a new device while waiting for emergency assistance

For pediatrics =

Usual Pediatric Dose for Hypoglycemia

Glucagon Emergency Kit and GlucaGen HypoKit:
-WEIGHT-BASED DOSING:
Glucagon: Less than 20 kg: 0.5 mg (or 20 to 30 mcg/kg) IM/IV or subcutaneously once
Glucagon: 20 kg or greater: 1 mg IM/IV or subcutaneously once
GlucaGen: Less than 25 kg: 0.5 mg IM/IV or subcutaneously once
GlucaGen: 25 kg or greater: 1 mg IM/IV or subcutaneously once
-AGE-BASED DOSING (when weight is unknown):
Less than 6 years: 0.5 mg IM/IV or subcutaneously once
6 years or older: 1 mg IM/IV or subcutaneously once

GVOKE Auto-Injector and Prefilled Syringes:
2 to 12 years (weight less than 45 kg): 0.5 mg subcutaneously once
2 to 12 years (weight 45 kg or greater): 1 mg subcutaneously once
12 years or older: 1 mg subcutaneously once

Adverse effects =

>10%

Gvoke

• Nausea (36-54%)
• Hypoglycemia (27-54%)
• Vomiting (14-23%)
• Headache (15%)
• Hyperglycemia (8-14%)

1-10%

GlucaGen

• Nausea (<10%)

Gvoke

• Injection site reaction (9%)
• Abdominal pain (8%)
• Injection site discomfort (8%)
• Urticaria (8%)

<1%

GlucaGen

• Vomiting
• Hypoglycemia
• Hypoglycemia coma

Interactions =2 type .in one type serious so alternative drug use and second closely monitor

Serious - Use Alternative

• aclidinium
• atropine
• benztropine
• dicyclomine
• glycopyrrolate
• glycopyrrolate inhaled
• hyoscyamine
• hyoscyamine spray
• ipratropium
• methscopolamine
• orphenadrine
• propantheline
• scopolamine
• tiotropium
• trihexyphenidyl
• tropicamide
• umeclidinium bromide
• umeclidinium bromide/vilanterol inhaled

Monitor Closely

• acebutolol
• atenolol
• betaxolol
• bisoprolol
• carvedilol
• celiprolol
• esmolol
• indomethacin
• insulin aspart
• insulin aspart protamine/insulin aspart
• insulin degludec
• insulin degludec/insulin aspart
• insulin detemir
• insulin glargine
• insulin glulisine
• insulin inhaled
• insulin isophane human/insulin regular human
• insulin lispro
• insulin lispro protamine/insulin lispro
• insulin NPH
• insulin regular human
• labetalol
• metoprolol
• nadolol
• nebivolol
• penbutolol
• pindolol
• propranolol
• sotalol
• timolol
• warfarin

Nursing Implications

Assessment & Drug Effects

• Be prepared to give IV glucose if patient fails to respond to glucagon. Notify physician immediately.
• Note: Patient usually awakens from (diabetic) hypoglycemic coma 5–20 min after glucagon injection. Give PO carbohydrate as soon as possible after patient regains consciousness.
• Note: After recovery from hypoglycemic reaction, symptoms such as headache, nausea, and weakness may persist.

Patient & Family Education

• Note: Physician may request that a responsible family member be taught how to administer glucagon SC or IM for patients with frequent or severe hypoglycemic reactions. Notify physician promptly whenever a hypoglycemic reaction occurs so the reason for the reaction can be determined.
• Review package insert and directions (see ADMINISTRATION).
• Do not breast feed while taking this drug without consulting physician.

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