Drug cards - Oral Glucose & Glucagon

generic name - oral glucose

oral glucose

trade name - oral glucose

Glutose, Insta-glucose

drug classification - oral glucose

hyperglycemic

supply - oral glucose

gel in toothpaste-like tube; tablets (NOT for EMS use)

mechanism of action - oral glucose

increases amount of circulating blood sugar, reverses signs/symptoms of hypoglycemia, including decreased LOC

indications - oral glucose

signs/symptoms of hypoglycemia: altered level of consciousness, glucometer reading less than 60 mg/dL (normal range = 70-110 mg/dL)

contraindications - oral glucose

patients who cannot protect their own airway (risk of aspiration) → must be alert enough to swallow, patients with NO gag reflex, head trauma

side effects - oral glucose

airway compromise, nausea/vomiting

dosage - oral glucose

one complete tube (15 grams) if possible + 2nd does ONLY IF blood sugar remains below 60 mg/dL → administered via standing order if indications are met

route of administration - oral glucose

orally, squirt gel or apply with tongue depressor between cheek and gum

special considerations - oral glucose

monitor airway closely if patient is at risk of aspiration, patient may become combative or confused upon improved level of consciousness, oral glucose has a short lifetime within the body → patient must eat something to maintain blood sugar levels

oral glucose may be administered in the local EMS systems if patients _____ before contact with medical control

blood sugar levels below 60 mg/dL, is alert to at least verbal stimuli, is able to sit upright and has good airway control and intact gag reflex

generic AND trade name - glucagon

Glucagon

drug classification - glucagon

amino acid peptide hormone

supply - glucagon

1 mg and 1 unit vial diluent

mechanism of action - glucagon

promotes conversion of glycogen to glucose in the liver → raises blood glucose levels

indication - glucagon

hypoglycemia (below 60 mg/dL) if unable to initiate an IV

contraindication - glucagon

patients with pheocromocytosis (tumor of adrenal gland - glucagon causes excess release of epi-/norepinephrine potentially leading to a hypertensive crisis)

side effects - glucagon

hypotension, nausea/vomiting, hypokalemia (low potassium in blood), bronchospasm, respiratory distress

adult dosage - glucagon

1 mg IM (intramuscular injection) → mix 1 mg with 1 mL diluent

pediatric dosage - glucagon

1 mg IM

special considerations - glucagon

monitor glucose concentrations before/after administration, once patient is awake → give oral glucose to prevent secondary hypoglycemia due to short duration of glucagon

why must glucagon be diluted prior to administration? And what must NOT be done to the mixed solution?

glucagon comes in powdered form, DO NOT shake the mixed solution, instead roll it gently prior to administration