|Reviewed by Clinical Practice Committee|
To treat hypoglycaemia
Glucagon stimulates synthesis of cyclic AMP, especially in liver and adipose tissue. Stimulates gluconeogenesis. In high doses, glucagon has a positive cardiac inotropic effect. Inhibits small-bowel motility and gastric acid secretion.
Glucagon is secreted by the alpha-cells of the pancreas and transported via the portal circulation to the liver where the major portion is bound. From the liver it is excreted into the bile. A lesser portion is distributed to other organs, particularly the kidneys which have a high binding capacity for it. It is degraded enzymatically in blood plasma and in the organs to which it is distributed. Metabolised primarily in the liver.
Increased blood glucose levels occur within 5-30 minutes after injection and fall to normal or hypoglycaemia levels within 1-2 hours. Half-life reported in adults is 8-18 minutes.
The data for the use of glucagon to treat neonatal hypoglycaemia are mostly from case series and reports.1, 2, 3 Glucose production in response to a glucagon 100 microgram/kg bolus was comparable in preterm, appropriately grown for age and small for gestational age infants.4
Generally well tolerated. May cause transient increase in blood pressure and pulse
|1||Carter PE, Lloyd DJ, Duffty P. Glucagon for hypoglycaemia in infants small for gestational age. Arch Dis Child. 1988;63:1264-6.|
|2||Charsha DS, McKinley PS, Whitfield JM. Glucagon infusion for treatment of hypoglycaemia: efficacy and safety in sick, preterm infants. Pediatrics. 2003;111:220-1.|
|3||Miralles RE, Lodha A, Perlman M, Moore AM. Experience with intravenous glucagon infusions as a treatment for resistant neonatal hypoglycaemia. Arch Pediatr Adolesc Med. 2002;156:999-1004.|
|4||Van Kempen AA, Ackermans MT, Endert E, Kok JH and Sauerwein HP. Glucose production in response to glucagon is comparable in preterm AGA and SGA infants. Clin Nutr. 2005;24:727-36.|
|5||Neonatal Medicines Formulary Consensus Group. Version 1, 18/05/2017|