Neonatal Intensive Care Drug Manual




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Pharmacodynamics

An effect on blood glucose is usually seen within 5–20 minutes after IV, IM or SC administration [11]. Response to an intravenous bolus persists for at least 45 minutes [13].



Pharmacokinetics

Adult data report half-life of 8–18 minutes.[7]



Practice points




References

1. The Australian Immunisation Handbook 10th edition 2013 (updated January 2014).

2. Rishovd A. Pediatric intramuscular injections: guidelines for best practice. MCN Am J Matern Child Nurs. 2014;39:107-12; quiz 13-4.

3. Hensel D, Morson GL, Preuss EA. Best practices in newborn injections. MCN Am J Matern Child Nurs. 2013;38:163-7; quiz 8-9.

4. Hosseinnezhad A, Black RM, Aeddula NR, Adhikari D, Trivedi N. Glucagon-induced pheochromocytoma crisis. Endocr Pract. 2011;17:e51-4.

5. Minamori Y, Yammoto M, Tanaka A, Takeda N, Yasuda K. Hazard of glucagon test in diabetic patients. Hypertensive crisis in asymptomatic pheochromocytoma. Diabetes Care. 1992;15:1437-8.

6. Sebel EF, Hull RD, Kleerekoper M, Stokes GS. Responses to glucagon in hypertensive patients with and without pheochromocytoma. Am J Med Sci. 1974;267:337-43.

7. Product Information: GlucaGen(R) intramuscular injection, intravenous injection, subcutaneous injection, glucagon rDNA origin intramuscular injection, intravenous injection, subcutaneous injection. Boehringer Ingelheim Pharmaceuticals, Inc. (per DailyMed), Ridgefield, CT, 2014.

8. Messerli FH, Kuchel O, Tolis G, Hamet P, Fraysse J, Genest J. Effects of beta-adrenergic blockade on plasma cyclic AMP and blood sugar responses to glucagon and isoproterenol in man. Int J Clin Pharmacol Biopharm. 1976;14:189-94.

9. Micromedex solutions. Glucagon. Accessed on 22 March 2017.

10. Carter PE, Lloyd DJ, Duffty P. Glucagon for hypoglycaemia in infants small for gestational age. Arch Dis Child. 1988;63:1264-6.

11. Charsha DS, McKinley PS, Whitfield JM. Glucagon infusion for treatment of hypoglycemia: efficacy and safety in sick, preterm infants. Pediatrics. 2003;111:220-1.

12. Hawdon JM, Aynsley-Green A, Ward Platt MP. Neonatal blood glucose concentrations: metabolic effects of intravenous glucagon and intragastric medium chain triglyceride. Arch Dis Child. 1993;68:255-61.

13. Miralles RE, Lodha A, Perlman M, Moore AM. Experience with intravenous glucagon infusions as a treatment for resistant neonatal hypoglycemia. Archives of Pediatrics & Adolescent Medicine. 2002;156:999-1004.

14. van Kempen AA, Ackermans MT, Endert E, Kok JH, Sauerwein HP. Glucose production in response to glucagon is comparable in preterm AGA and SGA infants. Clin Nutr. 2005;24:727-36.

15. Stevens TP, Guillet R. Use of glucagon to treat neonatal low-output congestive heart failure after maternal labetalol therapy. J Pediatr. 1995;127:151-3.

16. Boyd R, Ghosh A. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Glucagon for the treatment of symptomatic beta blocker overdose. Emerg Med J. 2003;20:266-7.

17. Belik J, Musey J, Trussell RA. Continuous infusion of glucagon induces severe hyponatremia and thrombocytopenia in a premature neonate. Pediatrics. 2001;107:595-7.

18. Coulthard MG, Hey EN. Glucagon is very unlikely to have caused hyponatremia. Pediatrics. 2002;109:985.

19. Mohnike K, Blankenstein O, Pfuetzner A, Potzsch S, Schober E, Steiner S, Hardy OT, Grimberg A, van Waarde WM. Long-term non-surgical therapy of severe persistent congenital hyperinsulinism with glucagon. Horm Res. 2008;70:59-64.

20. Wald M, Lawrenz K, Luckner D, Seimann R, Mohnike K, Schober E. Glucagon therapy as a possible cause of erythema necrolyticum migrans in two neonates with persistent hyperinsulinaemic hypoglycaemia. Eur J Pediatr. 2002;161:600-3.





Original version Date: 18/05/2017

Author: Neonatal Medicines Formulary Consensus Group

Current Version number: 3

TCH Version Date: 15-12-2020

Risk Rating: Low

Due for Review: 15-12-2025

Approval by: DTC

Approval Date: TBA


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Neonatal Intensive Care Drug Manual

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