Glucagon - Drug Sheet

Medications administered on your time Medication & Classification 1. 2. 3. 4. 5. 6. Name of drug (trade/generic) Dosage R/A All times due All classifications Safe dose 1. Generic: Glucagon Trade: GlucaGen 1.Drug Action 1. List the most common side effects/adverse reactions 2.Reason pt. is on medication. (Be specific) 2. List all significant nursing actions related to the administration of med to this patient and number them. 1. Pharmacodynamics: Stimulates hepatic production of glucose from glycogen stores (glycogenolysis). I. Most common side effects/adverse reactions Therapeutic Effect(s): Increase in blood glucose. EENT: epistaxis, eye redness, itchy eyes, itchy 2. Dosage:1mg IM Pharmacokinetics: Onset: within 10 minutes 3. Route of Administration: IM CNS: headache throat, nasal congestion, nasal discomfort, nasal itching, rhinorrhea, sneezing, watery eyes GI: nausea, vomiting Resp: cough Peak: 30 minutes Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS) 4. Scheduled times: PRN for low blood glucose 5. Classifications: Pancreatics Therapeutic: hormones Duration: 12-27 minutes Absorption: Well absorbed following IM Distribution: Unknown 6. Safe dose: IV IM SC (Adults and Children >25 kg): 1 mg; may be repeated in 15 min if necessary. 7. Is this medication a HIGH ALERT drug? No Metabolism: Extensively metabolized by the liver, plasma, and kidneys. Excretion: None listed Geriatric considerations: None listed 8. Is this medication a “Look alike/sound alike” drug? No 2. Reason patient is on med. Rescue medication for low blood glucose (Patient also on Glucose PO and Dextrose IV) II. Nursing actions: A. Assessment: 1.Assess for signs of hypoglycemia (sweating, hunger, weakness, headache, dizziness, tremor, irritability, tachycardia, anxiety) prior to and periodically during therapy. 2.Assess neurologic status throughout therapy. 3.Institute safety precautions to protect patient from injury caused by seizures, falling, or aspiration. 4.Feed patient supplemental carbohydrates orally to replenish liver glycogen and prevent secondary hypoglycemia as soon as possible after awakening. 5.Assess nutritional status. Patients who lack liver glycogen stores (starvation, chronic hypoglycemia, adrenal insufficiency) will require glucose instead of glucagon. 6.Assess for nausea and vomiting after administration of dose. Protect patients with depressed level of consciousness from aspiration by positioning on side; ensure that a suction unit is available. Notify health care professional if vomiting occurs; patient will require parenteral glucose to prevent recurrent hypoglycemia. 7.Lab Test Considerations: Monitor serum glucose levels throughout episode, during treatment, and for 3–4 hr after patient regains consciousness. Use of bedside fingerstick blood glucose determination methods is recommended for rapid results. Follow-up lab results may be ordered to validate fingerstick values, but do not delay treatment while awaiting lab results, as this could result in neurologic injury or death. 8.Large doses of glucagon may cause a ↓ in serum potassium concentrations. B. Administration: 1. Reconstitute with diluent supplied in kit by manufacturer. Inspect solution prior to use; use only clear, water-like solution. Solution is stable for 48 hr if refrigerated, 24 hr at room temperature. Unmixed medication should be stored at room temperature. 2.Administer supplemental carbohydrates IV or orally to facilitate increase of serum glucose levels. C. Teaching: 1. Teach patient and family signs and symptoms of hypoglycemia. Instruct patient to take oral glucose as soon as symptoms of hypoglycemia occur; glucagon is reserved for episodes when patient is unable to swallow because of decreased level of consciousness. 2.Home Care Issues: Instruct family on correct technique to prepare, draw up, and administer injection. Health care professional must be contacted immediately after each dose for orders regarding further therapy or adjustment of insulin dose or diet. 3.Advise family that patient should receive oral glucose when alertness returns. 4.Instruct family to position patient on side until fully alert. Explain that glucagon may cause nausea and vomiting. Aspiration may occur if patient vomits while lying on back. 5. Instruct patient to check expiration date monthly and to replace outdated medication immediately. 6.Review hypoglycemic medication regimen, diet, and exercise programs. 7.Patients with diabetes mellitus should carry a source of sugar (such as a packet of sugar or candy) and identification describing disease process and treatment regimen at all times Other: Negates response to Insulin (Patient also on Humalog)