Glucagon is a hypoglycemic drug that also has a spasmolytic effect.
Release form and composition
Glucagon is produced in the form of a lyophilisate for the preparation of an injection solution with the same active ingredient.
The drug is available in ampoules 666, 667, 668 and 669 and in vials. One ampoule 666 contains 0.001 g of glucagon hydrochloride and 0.049 g of lactose; 667 - 0.001 g of glucagon hydrochloride and glycerin with phenol; 668 - 0.01 g of glucagon hydrochloride and 0.14 g of lactose; 669 - 0.01 g of glucagon hydrochloride and glycerin with phenol. In vials, the lyophilized powder can be packaged in 1 mg (single dose) or 2 or 10 mg (reusable form). A solvent (5 or 10 ml) is also attached to the lyophilisate in the vial.
Indications for use
According to the instructions, Glucagon is used for:
- With hypoglycemic coma;
- With obstruction of the esophagus by foreign bodies;
- As a shock therapy in psychiatric patients;
- When beta-adrenergic blockers and BMKK intoxication;
- As an additional diagnostic tool for radiography of the stomach and intestines, MRI, computed tomography, angiography, hysterosalpingography, diagnosis of bleeding from the small intestine with technetium-labeled erythrocytes.
According to the instructions, Glucagon is not applicable when:
- The patient has an increased sensitivity to glucagon (including a history of beef or pork proteins);
- Pheochromocytoma (due to the risk of a sharp increase in blood pressure);
- Insulinoma (intravenous) due to the risk of paradoxical development of hypoglycemia;
- Diabetes mellitus (intravenous) due to the increased risk of hyperglycemia.
Dosing and Administration
According to the instructions, Glucagon is intended for subcutaneous, intramuscular or intravenous administration.
- When hypoglycemia in adults and children weighing more than 20 kg - 0.5-1 mg; with a weight of less than 20 kg - 0.5 mg (or 20-30 μg per kilogram of weight). Within 15 minutes after the first injection of the drug, you can enter it 1-2 times more in the same dosage;
- When conducting a study of the stomach - 2 mg intramuscularly or 0.5 mg intravenously;
- When conducting a study of the colon - 10 minutes before the procedure, 2 mg intramuscularly;
- In case of beta-adrenergic blocker intoxication, 5-150 mcg per kilogram of body weight by infusion intravenously, and then intravenously drip (rate 1-5 mg / h);
- In case of intoxication with BCCA, 2 mg intravenously once. Maintenance doses of Glucagon are selected depending on the condition of the patient individually;
- With obstruction of the esophagus by foreign bodies - 0.5-2 mg intravenously. After 10-12 minutes, repeated administration of the drug is possible.
Lyophilisate before administration must be dissolved with a solvent or sterile water for injection (if administered in doses of more than 2 mg).
The use of Glucagon at a concentration of more than 1 mg / ml is not acceptable.
When using Glucagon, adverse reactions may develop:
- Digestive system: nausea and vomiting;
- Cardiovascular system: tachycardia, transient increase in blood pressure;
- Allergic reactions: lowering blood pressure, bronchospasm, urticaria,
- Other: dehydration, hypokalemia, manifested by severe myasthenia, myalgia, decreased appetite, convulsions of certain muscle groups, arrhythmia.
When using Glucagon, it should be borne in mind that:
- During treatment, plasma glucose levels should be monitored;
- If the patient's body does not respond to the introduction of glucagon, dextrose should be administered intravenously;
- In patients with insulinoma, intravenous administration of the drug first causes hyperglycemia, and then hypoglycemia;
- An overdose of the drug is manifested by nausea, diarrhea, "indomitable" vomiting, dehydration, hypokalemia, increased blood pressure, tachycardia. In such cases, the patient requires symptomatic treatment. When "indomitable" vomiting is necessary to carry out rehydration and to compensate for the loss of potassium;
- Patients who have developed symptoms of hypoglycemia after the injection, you must enter dextrose (in any way);
- Patients with pheochromocytoma may experience a sudden and strong rise in blood pressure. In such situations, intravenous administration of 5-10 mg of phentolamine is required;
- Patients with diabetes should strictly follow the recommendations of the doctor to prevent the development of hypoglycemic conditions;
- The drug is ineffective in hypoglycemia on the background of a low-carb diet, adrenal insufficiency and chronic hypoglycemia, since it has an effect in the presence of glycogen in the liver;
- Prepared on the basis of the supplied solvent solution of the drug can be stored no more than 48 hours;
- The solution prepared on the basis of water for injections cannot be stored, it should be used immediately.
- The introduction of Glucagon on the background of the use of beta-blockers may cause the development of tachycardia and increased blood pressure;
- The drug enhances the effect of indirect coagulants and reduces the effect of insulin.
Structural analogues of Glucagon are HypoCyte and GlucoGen.
Terms and conditions of storage
The drug is stored in a cool place with limited access to children.