Nurse Noemi administers glucagon to her diabetic client, then monitors the client for adverse drug reactions and interactions. Which type of drug interacts adversely with glucagon?
A. Oral anticoagulants
B. Anabolic steroids
C. Beta-adrenergic blockers
D. Thiazide diuretics
Correct Answer: A. Oral anticoagulants
As a normal body protein, glucagon only interacts adversely with oral anticoagulants, increasing the anticoagulant effects. It doesn’t interact adversely with anabolic steroids, beta-adrenergic blockers, or thiazide diuretics. Glucagon is a medication used in the management and treatment of hypoglycemia, as an antidote to beta-blocker and calcium channel blocker overdose, anaphylaxis refractory to epinephrine, and to aid in passing food boluses. It is in the anti-hypoglycemic class of medications.
Option B: Administering doses of exogenous glucagon over the dose required can predictably result in adverse reactions requiring intervention. However, this is rare in the literature. Insulin antagonizes glucagon, but toxicity should not have treatment with insulin in most circumstances.
Option C: The transient hyperglycemia associated with glucagon administration is rarely life-threatening, and iatrogenic rebound hypoglycemia has a substantial risk of harm. Treatment should focus on mitigating the hypertensive response to glucagon with alpha-blocking agents and vasodilators.
Option D: Relative contraindications include use in neonates or children, which may not have sufficient glycogen stores, patients with known insulinoma, pheochromocytoma, or glucagon secreting tumor, and known lactose allergy (some formulations contain lactose).
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