Drug Reference
Antidotes
Glucagon
Pancreatic hormone (cAMP via glucagon receptor)
IndicationAdultPediatric
β-blocker overdoseAdult3–5 mg IV over 1–2 min, repeat to 10 mg; infusion = effective dose per hourPeds0.05 mg/kg, then 0.07 mg/kg/h
Anaphylaxis on β-blockerAdult1–5 mg IV over 5 min, then 5–15 mcg/minPeds-
HypoglycemiaAdult1 mg IM/SCPeds0.5 mg if < 25 kg
Indications
- β-blocker overdose
- Anaphylaxis refractory to epinephrine in β-blocked patients
- Hypoglycemia without IV access
Contraindications & cautions
- Pheochromocytoma
- Insulinoma
Key pearls
- Vomiting is very common: protect the airway
- Expensive and supplies run out quickly in large overdoses