Understanding Glucagon: Uses, Precautions, and Administration

Glucagon is a critical hormone used in emergency situations to treat severe hypoglycemia, particularly in individuals with diabetes. However, there are specific contraindications and situations where glucagon may be ineffective, making it essential for both patients and caregivers to understand its appropriate use. Certain conditions, such as chronic alcohol abuse, anorexia nervosa, and chronic liver disease, can hinder glucagon’s effectiveness. Additionally, drugs like sulfonylureas and warfarin may complicate its use, requiring careful consideration before administration.

For patients who are insulin-dependent or at high risk of hypoglycemia, it is crucial to have glucagon kits readily available. Training family members and caregivers on how to use glucagon is an important step in ensuring a rapid response in emergencies. It is recommended to prescribe two kits to account for potential breakage and encourage patients to carry one kit with them at all times. Proper storage is vital; glucagon should be kept protected from light and stored between 2-8 °C, although it can be stored at room temperature for short durations.

When administering glucagon, the kit typically contains a vial of powder and a pre-filled syringe with water for injection. Caregivers must know how to prepare the injection by dissolving the powder and ensuring the solution is clear before use. The correct dosage varies based on age and weight, with adults and children over 25 kg receiving 1 mg, while younger children receive 0.5 mg.

After glucagon administration, it is crucial to monitor the patient closely. Blood glucose levels should be checked within 10 to 15 minutes. If the patient remains unresponsive after 10 minutes, it is essential to seek emergency medical assistance. Once the patient regains consciousness, offering carbohydrates will help sustain their recovery and prevent relapse into hypoglycemia, which can occur due to insulin overdose or other factors.

Careful observation is necessary post-treatment, particularly for vulnerable populations, such as the elderly or those with existing health concerns. They may take longer to recover fully from hypoglycemia. It's important to avoid letting patients perform potentially hazardous activities, such as driving, for at least an hour after treatment, ensuring their safety and that of others around them.

In cases where hypoglycemia is caused by factors like medication overdose or concurrent health issues, hospitalization may be warranted. Ongoing monitoring and support from healthcare professionals can help manage the risk of serious complications and facilitate recovery. Overall, understanding glucagon's use, its limitations, and the necessary precautions can empower patients and caregivers to respond effectively in hypoglycemic emergencies.