Glucagon therapy

Wald M, Lawrenz K, Luckner D, Seimann R, Mohnike K, Schober E. Glucagon therapy as a possible cause of erythema necrolyticum migrans in two neonates with persistent hyperinsulinaemic hypoglycaemia. Eur J Pediatr 2002 161(ll) 600-3. 

Walter FG, Frye G, Mullen JT, Ekins BR, Khasigian PA. Amelioration of nifedipine poisoning associated with glucagon therapy. Ann Emerg Med 1993 22(7) 1234-7. 

Peterson CD, Leeder JS, and Sterner S (1984) Glucagon therapy for B-blocker overdose. Drug Intelligence Clinical Pharmacy 18 394-398. 

Phosphorylation is regulated by insulin and glucagon. Diabetes mellitus (in which the ratio of glucagon to insulin is increased) and glucagon therapy reduce the hepatic activity of PFK-2 and increase that of FBPase-2. The concentration of fructose-2,6-bisphosphate is thus reduced, thereby stimulating gluconeogenesis. 

Some clinicians believe that insulin or glucagon therapy for calcium channel antagonist poisoning should be used early in the course of therapy. Others reserve it for life-threatening symptoms not responsive to other therapy. More safety and effectiveness data are needed to define the place of these two agents in therapy. 

Vitamin D withdrawal is an obvious treatment for D toxicity (219). However, because of the 5—7 d half-life of plasma vitamin D and 20—30 d half-life of 25-hydroxy vitamin D, it may not be immediately successful. A prompt reduction in dietary calcium is also indicated to reduce hypercalcemia. Sodium phytate can aid in reducing intestinal calcium transport. Calcitonin glucagon and glucocorticoid therapy have also been reported to reduce semm calcium resulting from D intoxication (210). 

A 57-year-old man who was given glucagon developed massive thrombosis, which resolved after removal of glucagon infusion and medical therapy. 

Case CC, Vassilopoulou R. Reproduction of features of the glucagonoma syndrome with continuous intravenous glucagon infusion as therapy for tumor-induced hypoglycemia. Endocrine Pract 2003 9 22-5. 

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