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Pharmacology

Endocrine

Question 98 of 180

Glucagon may be used as an antidote for overdose with which of the following:

Answer:

Glucagon is mainly used as a treatment for hypoglycaemia but may also be used as an antidote in beta-blocker overdose and in anaphylaxis in patients on beta-blockers that fail to respond to adrenaline.

Glucagon Therapy

Pharmacology / Endocrine

Last Updated: 28th March 2019

Glucagon, a polypeptide hormone produced by the alpha cells of the islets of Langerhans, increases plasma-glucose by mobilising glycogen stored in the liver. Glucagon promotes glycogenolysis and gluconeogenesis and may be used to treat hypoglycaemia.

Glucagon may also be used as an antidote in beta-blocker overdose and in anaphylaxis in patients on beta-blockers that fail to respond to adrenaline.

Cautions

Glucagon may take up to 15 minutes to have an effect and will be less effective in alcoholics, prolonged starvation and severe liver disease when glycogen stores are depleted. In this situation or if prolonged treatment is required, IV glucose is better. Glucagon may also be less effective in patients prescribed sulfonylurea therapy.

Contraindications

Glucagon is contraindicated in pheochromocytoma.

Side Effects

Adverse effects include:

  • Common: Nausea
  • Uncommon: Vomiting
  • Rare: Abdominal pain, hypertension, hypotension, tachycardia

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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