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Standard Dilutions [Amount of drug] [Infusion volume] [Infusion rate]
| [Recommended concentration: 0.1 mg/ml]
[5 mg] [50 ml]
[10 mg] [100 ml]
[20 mg] [200 ml]
May be given as a bolus or continuous infusion (See Comments)
Stability / Miscellaneous
| Stability: Reconstituted solutions should be used immediately; any unused portion should be discarded.
After all of the vials have been reconstituted, follow the dilutions listed above: eg 10mg/100 ml D5W or NS.
Calcium Channel blocker overdose: [See beta-blocker protocol above or review the following excerpt from: S. Doyon. Calcium Channel Blocker Overdose - MARYLAND POISON CENTER. TOXALERT: Volume 17, Issue 1: January, 2000] The initial dose of glucagon is 3 mg IV over 1 minute. If ineffective, it should be followed by a 7 mg dose over 1 minute. The onset of action of glucagon is within 5 minutes and the duration of action is 15 minutes. Therefore, the bolus must be followed with an infusion of 3-5 mg or more per hour in order to support the heart rate and blood pressure. Hyperglycemia and vomiting are the adverse events most often associated with glucagon administration. It is, therefore, recommended that the patient have an NG tube placed followed by low wall suction, and that blood glucose be closely monitored with the administration of insulin to treat hyperglycemia (when blood sugars reach double the baseline).
Monitor blood glucose levels in hypoglycemic patients until they are asymptomatic; effective in treating hypoglycemia only if sufficient liver glycogen is present; since liver glycogen availability is necessary to treat hypoglycemic patients, glucagon has virtually no effects on patients in states of starvation, adrenal insufficiency, or chronic hypoglycemia.
Recommended routes: IM, IV, or SC.
DOSAGE AND ADMINISTRATION
Directions for Treatment of Severe Hypoglycemia:
1. If parenteral glucose can not be used, dissolve the lyophilized glucagon using the accompanying diluting solution and use immediately.
Directions for Use as a Diagnostic Aid:
The doses in the following table may be administered for relaxation of the stomach, duodenum, and small bowel, depending on the onset and duration of effect required for the examination. Since the stomach is less sensitive to the effect of glucagon, 0.5 mg (0.5 units) IV or 2 mg (2 units) IM are recommended.
For examination of the colon, it is recommended that a 2 mg (2 units) dose be administered intramuscularly approximately 10 minutes prior to the procedure. Colon relaxation and reduction of patient discomfort may allow the radiologist to perform a more satisfactory examination.
1 mg (1 unit) — (VL7529), with 1 mL of sterile water (1s) NDC 0002-8031-01
Stability and Storage:
The USP defines controlled room temperature by the following: A temperature maintained thermostatically that encompasses the usual and customary working environment of 20° to 25°C (68° to 77°F); that results in a mean kinetic temperature calculated to be not more than 25°C; and that allows for excursions between 15° and 30°C (59° and 86°F) that are experienced in pharmacies, hospitals, and warehouses.
After Reconstitution— Glucagon for Injection (rDNA origin) should be used immediately. Discard any unused portion.
Literature revised February 18, 2005
Source: [package insert]