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recombinant glucagon (Baqsimi)

Indications: 1) hypoglycemia - effective only in presence of hepatic glycogen stores - underprescribed, underutilized by paramedics [4] 2) diagnostic aid in radiologic examination of the GI tract when a hypotonic state is need (relaxes bowel) 3) beta-adrenergic receptor antagonist overdose 4) Ca+2 channel antagonist overdose Dosage: 1) hypoglycemia: 1 mg IV, IM, SC, may repeat every 20 min 2) ACLS, overdose beta blocker Ca+2 channel blocker - 1-5 mg over 2-5 minutes 3) diagnostic aid: 0.25-2 mg 10 min prior to procedure. 1 unit = 1 mg. * Baqsimi (nasal powder) Pharmacokinetics: 1) effects on blood glucose levels occur within 5-20 minutes following parenteral administration & persist for 60-90 minutes 2) elimination 1/2life 3-10 minutes Adverse effects: - not common (1-10%) - hypotension, urticaria, nausea, vomiting, respiratory distress, hypersensitivity reactions, Stevens-Johnson syndrome, hyperglycemia, hypokalemia Drug interactions: - may enhance anticoagulant effects of warfarin Mechanism of action: 1) increased production of hepatic cAMP 2) stimulates hepatic glycogenolysis & gluconeogenesis 3) increases blood glucose levels 4) beta-adrenergic receptor agonist, positive inotropic & chronotropic activities

Related

glucagon receptor; GL-R (GCGR)

Specific

glucagon pen (Gvoke HypoPen)

General

glucagon; contains: glicentin; glicentin-related polypeptide; GRPP; oxyntomodulin; OXM; OXY; glucagon-like peptide 1; GLP-1; glucagon-like peptide 1(7-37); GLP-1(7-37); glucagon-like peptide 1(7-36); GLP-1(7-36); glucagon-like peptide 2; GLP-2 (GCG) endocrine agent

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  3. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  4. Kahn PA, Wagner NE, Gabbay RA. Underutilization of glucagon in the prehospital setting. Ann Intern Med 2017 Dec 26 PMID: 29277850 http://annals.org/aim/article-abstract/2667621/underutilization-glucagon-prehospital-setting
  5. FDA News Release. July 24, 2019 FDA approves first treatment for severe hypoglycemia that can be administered without an injection. https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-severe-hypoglycemia-can-be-administered-without-injection