GLUCAGON not just for diabetics

[CrazyQ61]

I need to find resources for using glucagon in obstructed airway pts.
any with info please respond.

[This message has been edited by CrazyQ61 (edited June 21, 2000).]

[Medic 16]

I have never heard of such a thing. What did you read, see or hear about this. I'm curios.

[This message has been edited by Medic 16 (edited June 18, 2000).]

[FFD#60]

I looked up the indications and actions for glucagon. The only indications are for stimulation of the hepatic production of glycogen stores and also is used for relaxation of GI musculature facilitating radiographic examination. Didn't see anything on obstructed airway. I got this info from the Nurse's Davis's drug guide. I don't know, sounds interesting though.

[ncfd933]

My crew received orders to give Glucagon to a elderly pt who had a small piece of pork lodged at the top of his esophagus. We were informed that the glucagon would increase esophageal peristalitic motion and increase digestive juice production. It did not work. It could have been worse, the dispatch came in as a "Fork in a man's throat", not pork. This is the closest thing I can relate to using glucagon for an obstructed airway. Keep me informed. ncfd933

[firemedic1979]

for treatment of "Steakhouse Syndrome" in addition to other tx protocols, the following is advised:

Give 1 unit of glucagon iv to decrease lower esophageal sphincter pressure (infuse slowly to prevent nausea and vomiting). This will sometimes allow for passage of a food bolus. If there is no response, repeat after 30 minutes.
http://www.ncemi.org/cse/cse0602.htm

If you would like the full article on the subject. It suprised me when I saw it being done in the ER (thought the doc was looney!)(He is looney, but correct in this one case)

Forgot all about it till I saw your post.
Don Elston

[rlkaale]

This was a great question, and a use for glucagon I’ve never thought of. The theory behind the use of glucagon for esophageal obstruction relates to glucagon’s effect on esophageal smooth muscle. It has been proposed that in addition to some foreign body obstructing the esophagus, esophageal smooth muscle is stimulated to spasm. This, in turn, worsens the obstruction.

Glucagon, while primarily used in hypoglycemic patients to release liver stores of glucose into the blood, also has action on smooth muscle. Specifically, glucagon produces a relaxant effect on smooth musculature. Thus, glucagon has the potential to relax esophageal smooth muscle sufficiently to allow the foreign body to pass into the stomach to be eventually eliminated via the GI tract.

“Current Dx/Tx in Gastroenterology” says that the use of glucagon treatment really depends on location of the obstruction. Obviously, if the obstruction is also blocking the airway, do what you can to clear the airway immediately (Heimlich, forceps, etc.). If the obstruction is in lower esophagus, this is not life threatening, but still needs urgent care. Long story-short, glucagon is the last non-invasive option to clear the esophagus. It also may take at least 20-30 minutes to work. If it doesn’t work after 2 doses, then endoscopy is used as the last resort.

References:
A. USP DI - Drug Information for the Health Care Professional, 19th edition, 1999.
B. Current Diagnosis and Treatment in Gastroenterology, 1st edition, 1996.