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Pharmacologic class: Antihypoglycemic
Therapeutic class: Insulin antagonist
Pregnancy risk category B
Increases blood glucose concentration by converting glycogen in liver to glucose. Also relaxes GI smooth muscle.
Powder for injection: 1-mg vials
Indications and dosages
➣ Severe hypoglycemia
Adults and children weighing more than 20 kg (44 lb): 1 mg subcutaneously, I.M., or I.V.
Children weighing 20 kg (44 lb) or less: 20 to 30 mcg/kg or 0.5-mg dose subcutaneously, I.M., or I.V.
➣ Diagnostic aid for radiologic examination
Adults: 0.25 to 2 mg I.V. or 1 to 2 mg I.M. before radiologic procedure
• Hypersensitivity to drug
Use cautiously in:
• cardiac disease, adrenal insufficiency, chronic hypoglycemia
• history suggesting insulinoma or pheochromocytoma
• elderly patients
• pregnant or breastfeeding patients.
☞ Use only in hypoglycemic emergencies for patients with diabetes mellitus.
• Mix drug in 1-mg vial with 1 ml of diluent supplied by manufacturer.
• For I.V. injection, give 1 mg over 1 minute.
• Use drug immediately after preparing; discard unused portion.
☞ Patient should respond within 15 minutes. Because of potential serious adverse reactions linked to prolonged cerebral hypoglycemia, give I.V. glucose if patient fails to respond to glucagon.
• Give patient carbohydrate-rich foods as soon as he's alert.
• Dilute diagnostic aid doses above 2 mg with sterile water for injection.
GI: nausea, vomiting
Metabolic: hypokalemia (with overdose)
Respiratory: bronchospasm, respiratory distress
Skin: urticaria, rash
Drug-drug. Anticoagulants: enhanced anticoagulant effect
Drug-diagnostic tests. Potassium: decreased level
• Monitor blood glucose level.
• Monitor patient for aspiration.
• Assess blood pressure, electrolyte levels, and respiratory status.
• Teach patient and family members the proper technique and timing for using this emergency drug.
☞ Emphasize importance of contacting prescriber right away if hypoglycemic emergency occurs.
☞ Tell caregiver or family member to arouse patient immediately and give additional carbohydrate by mouth as soon as patient can tolerate it.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.