Drugs used to elevate glucose levels in blood

1. L6-Glucose-elevating agents
ALICE 2/28/2023
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ALICE BCM 329.

2. Glucose-elevating agents
• Glucose-elevating agents raise blood level of
glucose when severe hypoglycemia occurs at <40
mg/dL.
• Two agents are used to elevate glucose:
diazoxide and glucagon.
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ALICE BCM 329.

3. Glucose-elevating agents
• Therapeutic Action
• Increasing blood glucose by decreasing insulin
release and accelerating the breakdown of
glycogen in the liver to release glucose.
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ALICE BCM 329.

4. Glucose-elevating agents
• Indications
• Diazoxide- Oral formulations are indicated for
the management of hypoglycemia; A potent
antipressor..intravenous use for management of
severe hypertension.
• Glucagon is used to counteract severe
hypoglycemic reactions.
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ALICE BCM 329.

5. Glucose-elevating agents
Dosing and administration
Oral and parenteral formulations are available
The dosage is usually individualized.
Review the dosage guidelines@
https://www.drugs.com/dosage/glucagen.html
https://www.drugs.com/dosage/proglycem.html
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ALICE BCM 329.

6. Glucose-elevating agents
• Pharmacokinetics for IV
ROUTE ONSET PEAK DURATION
IV 1min 15 min 9-20 min
T1/2: 3-10 min
Metabolism: liver
Excretion: bile,
urine
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ALICE BCM 329.

7. Glucose-elevating agents
• Contraindications and Cautions
• Diazoxide is contraindicated with known
allergies to sulfonamides or thiazides.
• Pregnancy and lactation. Associated with
adverse effects to fetus and baby.
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ALICE BCM 329.

8. Glucose-elevating agents
• Contraindications and Cautions
• There are no adequate studies on glucagon and
pregnancy, so use should be reserved for those
situations in which the benefits to the mother
outweigh any potential risks to the fetus.
• Caution should be used in patients with renal or
hepatic dysfunction or cardiovascular disease.
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ALICE BCM 329.

9. Glucose-elevating agents
• Adverse Effects
• Glucagon is associated with GI upset, nausea,
and vomiting.
• Diazoxide is associated with vascular effects,
including hypotension, headache, cerebral
ischemia, weakness, heart failure, and
arrhythmias.
• This is because diazoxide has the ability to relax
arteriolar smooth muscle.
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ALICE BCM 329.

10. Glucose-elevating agents
• Interactions
• Diazoxide with thiazide diuretics can increase
risk of toxicity because these two are structurally
the same.
• Glucagon with oral anticoagulants will increase
anticoagulation effects.
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ALICE BCM 329.

11. Glucose-elevating agents
• Vital interventions
• Monitor blood glucose levels to evaluate the
effectiveness of the drug.
• Have insulin on standby during emergency use
to treat severe hyperglycemia if it occurs as a
result of overdose.
• Monitor nutritional status
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ALICE BCM 329.

12. Glucose-elevating agents
• Monitor patients receiving diazoxide for
potential cardiovascular effects, including blood
pressure, heart rhythm and output, and weight
changes to avert serious adverse reactions.
• Provide comfort measures to help patient cope
with drug effects.
• Provide patient education about drug effects and
warning signs to report to enhance patient
knowledge and to promote compliance.
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ALICE BCM 329.

13. Glucose-elevating agents
• Monitor patient response to therapy
(stabilization of blood glucose levels).
• Monitor for adverse effects (hyperglycemia and
GI distress).
• Evaluate patient understanding on drug therapy
by asking patient to name the drug, its
indication, and adverse effects to watch for.
• Monitor patient compliance to drug therapy.
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ALICE BCM 329.