Educational use only. Drug cards are AI-assisted study material for NCLEX preparation.
Glucagon (GlucaGen, Baqsimi, Gvoke)
Mechanism of action
Stimulates hepatic glycogenolysis and gluconeogenesis, raising blood glucose within minutes. Requires adequate hepatic glycogen stores — works less reliably in malnutrition, prolonged fasting, alcohol-induced hypoglycemia, or chronic liver disease. Also relaxes GI smooth muscle (used as a smooth-muscle relaxant for some procedures and for esophageal foreign-body impaction).
Adverse effects
Life-threatening / NCLEX-tested
- Severe hypertension or tachycardia in patients with pheochromocytoma or insulinoma
- Severe hypoglycemia rebound after the initial glucose rise (give a meal/snack as soon as the patient can swallow)
- Anaphylaxis (rare)
Side effects
Common — what to teach
- Nausea and vomiting (very common — protect airway after IM dose if patient is still stuporous)
- Mild headache
- Mild abdominal discomfort
- Injection-site irritation
Food & drug interactions
Anticoagulants — glucagon may potentiate warfarin effect. Beta blockers may blunt hyperglycemic response in some patients but glucagon is still the right first move in severe hypoglycemia in a beta-blocker-treated patient.
Nursing implications
Assessment, monitoring, patient teaching
- Indication: SEVERE hypoglycemia in a patient who is unconscious, seizing, or unable to safely swallow — IM 1 mg adult / weight-based pediatric, or intranasal 3 mg (Baqsimi) / SC autoinjector (Gvoke)
- After administration: place patient in recovery position (left lateral) — vomiting is very common; protect airway
- Recheck blood glucose in 10–15 minutes; expect a rise of 50–100 mg/dL in 5–20 minutes
- AS SOON AS the patient is awake and able to swallow safely, give a complex carb + protein snack to PREVENT rebound hypoglycemia (glucagon's effect is brief)
- Patient/family teaching: keep one glucagon kit at home and at school/work; train at least two household members in the procedure; check expiration
- If glucagon fails or is unavailable, IV dextrose (D50) is the in-hospital alternative
- For procedural use as a smooth-muscle relaxant (e.g., reducing esophageal food impaction), follow the procedural protocol — different dosing and indications
When to hold / contraindications
- Pheochromocytoma (severe hypertensive crisis risk)
- Insulinoma (paradoxical worsening of hypoglycemia)
- Patient who is conscious and able to swallow safely — give oral fast carbs (15 g) instead
- Glycogen-depleted states where efficacy is poor (prolonged fasting, alcohol-induced hypoglycemia, end-stage liver disease) — IV dextrose is preferred
Memory anchor
Glucagon = "the unconscious diabetic's first move." Recovery position, expect vomiting, recheck in 15 min, follow with a snack to prevent rebound.
Practice Glucagon questions
Test your recall on real NCLEX-style pharmacology questions — with full rationales and an AI Coach for the parts you miss.