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Glucagon

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Overview

What is Glucagon?

Glucagon for Injection is a polypeptide hormone identical to human glucagon that increases blood glucose and relaxes smooth muscle of the gastrointestinal tract. Glucagon is synthesized in a special non-pathogenic laboratory strain of bacteria that has been genetically altered by the addition of the gene for glucagon.

Glucagon is a single-chain polypeptide that contains 29 amino acid residues and has a molecular weight of 3483.

The empirical formula is CHNOS. The primary sequence of glucagon is shown below.

Crystalline glucagon is a white to off-white powder. It is relatively insoluble in water but is soluble at a pH of less than 3 or more than 9.5.

Glucagon is available for use intravenously, intramuscularly, or subcutaneously in a kit that contains a vial of sterile glucagon and a syringe of sterile diluent. The vial contains 1 mg of glucagon and 49 mg of lactose. Hydrochloric acid may have been added during manufacture to adjust the pH of the glucagon. One International Unit of glucagon is equivalent to 1 mg of glucagon. The diluent syringe contains 12 mg/mL of glycerin, Water For Injection, and hydrochloric acid.



What does Glucagon look like?



What are the available doses of Glucagon?

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What should I talk to my health care provider before I take Glucagon?

Sorry No records found

How should I use Glucagon?

For the treatment of severe hypoglycemia:

Glucagon is indicated as a treatment for severe hypoglycemia (low blood sugar) which may occur in patients with diabetes mellitus.

Because patients with type 1 diabetes may have less of an increase in blood glucose levels compared with a stable type 2 patient, supplementary carbohydrate should be given as soon as possible, especially to a pediatric patient.

General Instructions for Use:


What interacts with Glucagon?


Glucagon is contraindicated in patients with known hypersensitivity to it or in patients with known pheochromocytoma.



What are the warnings of Glucagon?



Glucagon should be administered cautiously to patients with a history suggestive of insulinoma, pheochromocytoma, or both. In patients with insulinoma, intravenous administration of glucagon may produce an initial increase in blood glucose; however, because of glucagon's hyperglycemic effect the insulinoma may release insulin and cause subsequent hypoglycemia. A patient developing symptoms of hypoglycemia after a dose of glucagon should be given glucose orally, intravenously, or by gavage, whichever is most appropriate.



Exogenous glucagon also stimulates the release of catecholamines. In the presence of pheochromocytoma, glucagon can cause the tumor to release catecholamines, which may result in a sudden and marked increase in blood pressure. If a patient develops a sudden increase in blood pressure, 5 to 10 mg of phentolamine mesylate may be administered intravenously in an attempt to control the blood pressure.



Generalized allergic reactions, including urticaria, respiratory distress, and hypotension, have been reported in patients who received glucagon by injection.


What are the precautions of Glucagon?

General

Glucagon is effective in treating hypoglycemia only if sufficient liver glycogen is present. Because glucagon is of little or no help in states of starvation, adrenal insufficiency, or chronic hypoglycemia, hypoglycemia in these conditions should be treated with glucose.

Information for Patients



Refer patients and family members to the attached Information for the User for instructions describing the method of preparing and injecting glucagon. Advise the patient and family members to become familiar with the technique of preparing glucagon before an emergency arises. Instruct patients to use 1 mg for adults and 1/2 the adult dose (0.5 mg) for pediatric patients weighing less than 44 lb (20 kg).



Patients and family members should be informed of the following measures to prevent hypoglycemic reactions due to insulin:

To prevent severe hypoglycemia, patients and family members should be informed of the symptoms of mild hypoglycemia and how to treat it appropriately.

Family members should be informed to arouse the patient as quickly as possible because prolonged hypoglycemia may result in damage to the central nervous system. Glucagon or intravenous glucose should awaken the patient sufficiently so that oral carbohydrates may be taken.

Patients should be advised to inform their physician when hypoglycemic reactions occur so that the treatment regimen may be adjusted if necessary.

Laboratory Tests

Blood glucose determinations should be obtained to follow the patient with hypoglycemia until patient is asymptomatic.

Carcinogenesis, Mutagenesis, Impairment of Fertility



Because glucagon is usually given in a single dose and has a very short half-life, no studies have been done regarding carcinogenesis. In a series of studies examining effects on the bacterial mutagenesis (Ames) assay, it was determined that in colony counts was related to technical difficulties in running this assay with peptides and was not due to mutagenic activities of the glucagon.



Reproduction studies have been performed in rats at doses up to 2 mg/kg glucagon administered two times a day (up to 40 times the human dose based on body surface area, mg/m) and have revealed no evidence of impaired fertility.

Pregnancy

Reproduction studies have not been performed with recombinant glucagon. However, studies with animal-sourced glucagon were performed in rats at doses up to 2 mg/kg glucagon administered two times a day (up to 40 times the human dose based on body surface area, mg/m), and have revealed no evidence of impaired fertility or harm to the fetus due to glucagon. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

Nursing Mothers

It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when glucagon is administered to a nursing woman. If the drug is excreted in human milk during its short half-life, it will be hydrolyzed and absorbed like any other polypeptide. Glucagon is not active when taken orally because it is destroyed in the gastrointestinal tract before it can be absorbed.

Pediatric Use



For the treatment of severe hypoglycemia: The use of glucagon in pediatric patients has been reported to be safe and effective.



For use as a diagnostic aid: Effectiveness has not been established in pediatric patients.

Geriatric Use

Clinical studies of glucagon did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.


What are the side effects of Glucagon?

Side effects may include nausea and vomiting. These reactions may also occur with hypoglycemia. Generalized allergic reactions have been reported ( ). In a three month controlled study of 75 volunteers comparing animal-sourced glucagon with glucagon manufactured through rDNA technology, no glucagon-specific antibodies were detected in either treatment group.


What should I look out for while using Glucagon?


What might happen if I take too much Glucagon?


How should I store and handle Glucagon?

Clarithromycin tablets, USP 500 mg are white, oval-shaped, film-coated tablets, debossed GG C9 on one side and plain on the reverse side, and are supplied as follows:NDC 68788-6425-1 in bottles of 14 tabletsNDC 68788-6425-2 in bottles of 20 tabletsNDC 68788-6425 -8 in bottles of 28 tabletsNDC 68788-6425-3 in bottles of 30 tabletsStore at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].Dispense in a tight container as described in the USP. Protect from light.Clarithromycin tablets, USP 500 mg are white, oval-shaped, film-coated tablets, debossed GG C9 on one side and plain on the reverse side, and are supplied as follows:NDC 68788-6425-1 in bottles of 14 tabletsNDC 68788-6425-2 in bottles of 20 tabletsNDC 68788-6425 -8 in bottles of 28 tabletsNDC 68788-6425-3 in bottles of 30 tabletsStore at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].Dispense in a tight container as described in the USP. Protect from light.Clarithromycin tablets, USP 500 mg are white, oval-shaped, film-coated tablets, debossed GG C9 on one side and plain on the reverse side, and are supplied as follows:NDC 68788-6425-1 in bottles of 14 tabletsNDC 68788-6425-2 in bottles of 20 tabletsNDC 68788-6425 -8 in bottles of 28 tabletsNDC 68788-6425-3 in bottles of 30 tabletsStore at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].Dispense in a tight container as described in the USP. Protect from light.Clarithromycin tablets, USP 500 mg are white, oval-shaped, film-coated tablets, debossed GG C9 on one side and plain on the reverse side, and are supplied as follows:NDC 68788-6425-1 in bottles of 14 tabletsNDC 68788-6425-2 in bottles of 20 tabletsNDC 68788-6425 -8 in bottles of 28 tabletsNDC 68788-6425-3 in bottles of 30 tabletsStore at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].Dispense in a tight container as described in the USP. Protect from light.Clarithromycin tablets, USP 500 mg are white, oval-shaped, film-coated tablets, debossed GG C9 on one side and plain on the reverse side, and are supplied as follows:NDC 68788-6425-1 in bottles of 14 tabletsNDC 68788-6425-2 in bottles of 20 tabletsNDC 68788-6425 -8 in bottles of 28 tabletsNDC 68788-6425-3 in bottles of 30 tabletsStore at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].Dispense in a tight container as described in the USP. Protect from light.Clarithromycin tablets, USP 500 mg are white, oval-shaped, film-coated tablets, debossed GG C9 on one side and plain on the reverse side, and are supplied as follows:NDC 68788-6425-1 in bottles of 14 tabletsNDC 68788-6425-2 in bottles of 20 tabletsNDC 68788-6425 -8 in bottles of 28 tabletsNDC 68788-6425-3 in bottles of 30 tabletsStore at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].Dispense in a tight container as described in the USP. Protect from light.Clarithromycin tablets, USP 500 mg are white, oval-shaped, film-coated tablets, debossed GG C9 on one side and plain on the reverse side, and are supplied as follows:NDC 68788-6425-1 in bottles of 14 tabletsNDC 68788-6425-2 in bottles of 20 tabletsNDC 68788-6425 -8 in bottles of 28 tabletsNDC 68788-6425-3 in bottles of 30 tabletsStore at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].Dispense in a tight container as described in the USP. Protect from light.


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Clinical Information

Chemical Structure

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Clinical Pharmacology

Glucagon increases blood glucose concentration and is used in the treatment of severe hypoglycemia. Glucagon acts only on liver glycogen, converting it to glucose.

Glucagon administered through a parenteral route relaxes smooth muscle of the stomach, duodenum, small bowel, and colon.

Non-Clinical Toxicology
Because tetracyclines have been shown to depress plasma prothrombin activity, patients who are on anticoagulant therapy may require downward adjustment of their anticoagulant dosage.

Since bacteriostatic drugs may interfere with the bactericidal action of penicillin, it is advisable to avoid giving tetracyclines in conjunction with penicillin.

Absorption of tetracyclines is impaired by antacids containing aluminum, calcium, or magnesium, and iron-containing preparations.

Absorption of tetracyclines is impaired by bismuth subsalicylate.

Barbiturates, carbamazepine, and phenytoin decrease the half-life of doxycycline.

The concurrent use of tetracycline and Penthrane (methoxyflurane) has been reported to result in fatal renal toxicity.

Concurrent use of tetracycline may render oral contraceptives less effective.

Side effects may include nausea and vomiting. These reactions may also occur with hypoglycemia. Generalized allergic reactions have been reported ( ). In a three month controlled study of 75 volunteers comparing animal-sourced glucagon with glucagon manufactured through rDNA technology, no glucagon-specific antibodies were detected in either treatment group.

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Reference

This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"

While we update our database periodically, we cannot guarantee it is always updated to the latest version.

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Professional

Clonazepam Description Each single-scored tablet, for oral administration, contains 0.5 mg, 1 mg, or 2 mg Clonazepam, USP, a benzodiazepine. Each tablet also contains corn starch, lactose monohydrate, magnesium stearate, microcrystalline cellulose, and povidone. Clonazepam tablets USP 0.5 mg contain Yellow D&C No. 10 Aluminum Lake. Clonazepam tablets USP 1 mg contain Yellow D&C No. 10 Aluminum Lake, as well as FD&C Blue No. 1 Aluminum Lake. Chemically, Clonazepam, USP is 5-(o-chlorophenyl)-1,3-dihydro-7-nitro-2H-1,4-benzodiazepin-2-one. It is a light yellow crystalline powder. It has the following structural formula: C15H10ClN3O3 M.W. 315.72
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Tips

Tips

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Interactions

Interactions

A total of 440 drugs (1549 brand and generic names) are known to interact with Imbruvica (ibrutinib). 228 major drug interactions (854 brand and generic names) 210 moderate drug interactions (691 brand and generic names) 2 minor drug interactions (4 brand and generic names) Show all medications in the database that may interact with Imbruvica (ibrutinib).