II. Physiology
- Endogenous polypeptide Hormone
- Secreted by pancreatic alpha cells
- Opposite effect of Insulin
- While Insulin lowers Serum Glucose (glycogen storage, Glycolysis), Glucagon increases Serum Glucose
- However, both Insulin and Glucagon increase Amino Acid uptake from the liver
-
Hypoglycemia effect (primary)
- Hypoglycemia Increases pancreatic secretion of Glucagon
- Glucagon stimulates Glucose release from glycogen (glycogenolysis)
- Glucagon also stimulates Glucose synthesis (Gluconeogenesis)
- Inhibitors of Glucagon release
- Hyperglycemia
- Inhibits pancreatic secretion of Glucagon
- GLP1 (Incretin)
- Secreted by Small Bowel
- Stimulates pancreatic beta cells and inhibits Glucagon
- See Incretin Mimetics (used in Type 2 Diabetes Mellitus)
- Hyperglycemia
-
Amino Acid Excess Effect
- Increases pancreatic secretion of Glucagon
- Glucagon stimulates liver uptake of Amino Acids
- Both Insulin and Glucagon increase liver uptake of Amino Acids
- Acts at Catecholamine-independent receptors on cardiac cells
- Increases intracellular Calcium in cardiac cells
- Increases myocardial contractions
III. Pathophysiology
- Glucagonomas
- Glucagon Secreting tumor resulting in Diabetes Mellitus, as well as dermatitis (necrolytic migratory erythema)
IV. Indications: Glucagon Administration
-
Hypoglycemia
- Hypoglycemia with difficult Intravenous Access
- Neonatal Hypoglycemia
-
Esophageal Foreign Body
- Relaxes Lower esophageal tone
- Calcium Channel Blocker Overdose and Beta Blocker Overdose
V. Pharmacokinetics
- Onset of action: 5 to 20 minutes
VI. Preparations
- Background
- Cost approximately $280 for each agent (in 2019)
- Shelf-life: 2 years
- GlucaGen Hypokit (IM)
- Standard IM Injection
- Gvoke (SC)
- Subcutaneous Injection using a prefilled syringer (autoinjector release pending in 2020)
- Bagsimi (Intranasal)
- Powder sprayed into a single nostril
VII. Dosing: Hypoglycemia
- Adult: 1 mg IV, IM or SC
- Pediatric
- Standard dose: 30 ug/kg IM
- Newborn of diabetic mother: 300 ug/kg IM
- Maximum dose: 1 mg
VIII. References
- Goldberg (2014) Clinical Physiology, Medmasters, Miami, 140-1
- (2019) Presc Lett 26(11): 62-3
Images: Related links to external sites (from Bing)
Related Studies
glucagon (on 6/22/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
GLUCAGON 1 MG EMERGENCY KIT | Generic | $224.95 each |
glucagen (on 6/22/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
GLUCAGEN 1 MG HYPOKIT | $272.94 each | |
gvoke (on 2/1/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
GVOKE HYPOPEN 1-PK 1 MG/0.2 ML | $1,427.39 per ml | |
GVOKE HYPOPEN 2PK 0.5 MG/0.1 ML | $2,853.59 per ml | |
GVOKE HYPOPEN 2-PK 1 MG/0.2 ML | $1,423.08 per ml | |
GVOKE PFS 1-PK 1 MG/0.2 ML SYR | $1,426.19 per ml | |
GVOKE PFS 2-PK 1 MG/0.2 ML SYR | $1,424.86 per ml |
Ontology: Glucagon (C0017687)
Definition (NCI_NCI-GLOSS) | A hormone produced by the pancreas that increases the level of glucose (sugar) in the blood. |
Definition (NCI) | A pancreatic hormone consisting of 29 amino acids that causes increases in blood sugar levels by stimulating hepatic glycogenolysis and gluconeogenesis. |
Definition (CSP) | pancreatic hormone secreted by the alpha cells of the pancreatic islets; a 29-amino acid straight chain polypeptide that plays an important role in regulation of blood glucose concentration, ketone metabolism, and several other biochemical and physiological processes. |
Definition (MSH) | A 29-amino acid pancreatic peptide derived from proglucagon which is also the precursor of intestinal GLUCAGON-LIKE PEPTIDES. Glucagon is secreted by PANCREATIC ALPHA CELLS and plays an important role in regulation of BLOOD GLUCOSE concentration, ketone metabolism, and several other biochemical and physiological processes. (From Gilman et al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 9th ed, p1511) |
Concepts | Pharmacologic Substance (T121) , Neuroreactive Substance or Biogenic Amine (T124) , Hormone (T125) , Amino Acid, Peptide, or Protein (T116) |
MSH | D005934 |
SnomedCT | 10712001, 66603002 |
LNC | LP32562-8, LP14667-7, MTHU005175 |
English | Glucagon, Glucagon (1-29), Proglucagon (33-61), glucagon, Glucagon preparation, Hyperglycemic-Glycogenolytic Factor, HG Factor, HG-Factor, Glukagon, glucagon (medication), GLUCAGON, Glucagon [Chemical/Ingredient], glucagons, antidiabetic hormone, Glucagon product, Glucagon (substance), Glucagon product (product), Hyperglycaemic-glycogenolytic factor product, Hyperglycemic-glycogenolytic factor product, Glucagon, NOS, Hyperglycemic-glycogenolytic factor preparation, Hyperglycaemic-glycogenolytic factor preparation, Glucagon preparation (substance), Hyperglycemic Glycogenolytic Factor, GCG, Antidiabetic Hormone |
German | Glucagon, Glukagon (1-29), Glukagon, Glucagon (1-29), Hyperglykämisch-glykogenolytischer Faktor, HG-Faktor |
Swedish | Glukagon |
Czech | glukagon |
Finnish | Glukagoni |
Italian | Fattore glicogenolitico iperglicemico, Pro-glucagone, Fattore HG, Glucagone |
Russian | GLIUKAGON, ГЛЮКАГОН |
Spanish | preparado con glucagón (producto), preparado con glucagón, preparado con factor hiperglucemiante-glucogenolítico, producto con glucagón (producto), glucagón (producto), producto con factor hiperglucemiante-glucogenolítico, producto con glucagón, glucagón (sustancia), glucagón, preparado de factor hiperglucemiante-glucogenolítico, preparado de glucagón (producto), preparado de glucagón (sustancia), preparado de glucagón, Glucagón |
Japanese | グルカゴン |
Croatian | GLUKAGON |
Polish | Glukagon |
Norwegian | Hyperglykemisk-glykogenolytisk faktor, Proglukagon (33-61), Glukagon, HG-faktor, Glukagon (1-29) |
French | Glucagon, Facteur glycogénolytique hyperglycémique, Glucagon (1-29) |
Portuguese | Glucagon |
Ontology: GlucaGen (C0591569)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
English | GlucaGen kit, glucagen, GlucaGen |