Question about Glucagon adverse reactions?

[grumpymedic4]

for the n/v give zofran or phernegan or some other antiemetic, both can be given i.m.

[retired_medic61]

I have administered Glucagon in the past and none of the patients have vomited as a result. All medications have nausea and vomiting as a possible side effect. Glucagon is not really effective in someone who has liver damage such as an alcoholic or someone with liver disease.

Sometimes it is difficult to get a good IV line established in a hypoglycemic patient especially if they are combative. I have seen it work great in these situations. After you administer the glucagon, go ahead and start your IV and administer the Dextrose. The effects of the Glucagon will not last long at all and the glucose level will drop again pretty soon.

[AZCEP]

Glucagon is not really effective in someone who has liver damage such as an alcoholic or someone with liver disease...

After you administer the glucagon, go ahead and start your IV and administer the Dextrose. The effects of the Glucagon will not last long at all and the glucose level will drop again pretty soon.

In these groups we need to remember how the drug is working, as to why it isn't giving the response we want.

If the Glucagon gives you a response (read: the patient wakes up, and can follow commands) a better subsequent action is to provide them with something to eat with more nutritional value than a pre-filled syringe of D50 has. The D50 follow up will work, but if the patient can eat something, it will give a longer duration of effect than straight sugar can.

And of course, re-check the BGL every few minutes to trend the changes.

[ladyfirefighter36]

We just recently started carrying glucagon. I am so glad we did. We have a regular diabetic that we transport. He is always totally out of it, cannot give oral glucose. He is posturing and combative, so starting an IV for D50 hasn't been working either. He jerks and out they come. Twice in the last week we were able to give glucagon, bring the patient around, and load on the cot. Neither patient has complained of nausea, or had vomiting. Just acted like a happy drunk. Real chatty and loud. Better than the alternative.

[retired_medic61]

In these groups we need to remember how the drug is working, as to why it isn't giving the response we want.

If the Glucagon gives you a response (read: the patient wakes up, and can follow commands) a better subsequent action is to provide them with something to eat with more nutritional value than a pre-filled syringe of D50 has. The D50 follow up will work, but if the patient can eat something, it will give a longer duration of effect than straight sugar can.

And of course, re-check the BGL every few minutes to trend the changes.

True; however, many times during a transport the glucose level will drop and the patient will need to have D50 enroute. That is what I was trying to say. Yes, we do monitor glucose enroute and I have done so typically about 10 minutes after the med admin or if the patient starts to exhibit signs of hypoglycemia before that.

While we are on that subject I am going to say I have heard of medics who admin D50, obtain a refusal and back to the station. You pointed out a fact that D50 is also a tempoary fix and that the patients needs something to eat with nutritional value. So to all medics who slam their patients with D50 and go home, be careful, the patients glucose is apt to drop again soon unless they get something to eat.

I should have made myself clear that I was referring to a patient that is being transported. I don't have steak and baked potatoes on my unit.

[AZCEP]

Now that would be something I could fully support.