Glucagon for sedation emergencies means one thing: hypoglycemia that does not resolve with oral glucose, or that develops in a patient who cannot safely take anything by mouth during moderate sedation. It works by raising blood glucose through glycogen breakdown in the liver, which is why it does nothing for a patient whose glycogen stores are already depleted.
Dosage:
Dose: 0.25-0.5 mg
Onset of action: 1 minute
Duration of effect: 9-17 minutes
-OR-
Dose: 2 mg*
Onset of action: 1 minute
Duration of action: 22-25 minutes
*Use of 2mg dose produces a higher incidence of nausea and vomiting than do lower doses.
Reversal Agent:
None
Glucagon in Moderate Sedation
Glucagon is the emergency response to hypoglycemia recognized during moderate sedation — confirmed or strongly suspected by a low point-of-care glucose reading together with the patient’s signs. After the dose, recheck blood glucose within a few minutes rather than waiting out the full onset window, and be ready to give oral or IV glucose as soon as the patient can safely take it, since glucagon’s effect is temporary and a rebound low can follow once its glycogen-releasing effect wears off. It will not work in a patient with depleted liver glycogen stores — from prolonged fasting, alcohol use, or adrenal insufficiency — who needs IV dextrose instead. There is no reversal agent; the response is monitored by repeat glucose checks. As with any medication given during moderate sedation, administration follows the facility’s sedation policy and the provider’s scope of practice.
Educational reference for sedation providers, relocated from the previous version of this site — not a substitute for the current package insert, your facility protocols, or clinical judgment. Verify all doses against current references before clinical use.