Intranasal Glucagon for pre-hospital hypoglycaemia

Successful Administration of Intranasal Glucagon in the Out-of-Hospital Environment

Prehospital Emergency Care Posted online on September 12, 2012.

The effectiveness of the intranasal (IN) drug route has been reported for several drugs in the pre-hospital environment, for example fentanyl, midazolam and naloxone, this article presents a case of successful prehospital treatment of hypoglycemia with IN glucagon.

Episodes of hypoglycemia can be of varying severity and often requires quick reversal to prevent alteration in mental status or hypoglycemic coma. Glucagon has been shown to be as effective as glucose for the treatment of hypoglycemia. The inability to obtain intravenous (IV) access often impairs delivery of this peptide and is therefore frequently given via the intramuscular (IM) route. Intranasal administration of glucagon has been shown to be as effective as the IV route and may be used for rapid correction of hypoglycemic episodes where IV access is difficult or unavailable and IM administration is undesirable.

The authors describe what they believe is the first documentation in the peer-reviewed literature of the successful treatment and reversal of an insulin-induced hypoglycemic episode with IN glucagon in the prehospital setting. The article also presents a review of the literature regarding this novel medication administration route.

http://informahealthcare.com/doi/abs/10.3109/10903127.2012.717171

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