A potential role for glucagon in the treatment of drug-induced symptomatic bradycardia.
Nine cases of symptomatic bradycardia are presented in which treatment with intravenous glucagon was administered when atropine failed to improve the patient's condition significantly. Although the cause often was not obvious at presentation, all nine subjects took oral medications that could have contributed to the development of symptomatic bradycardia. Eight of nine patients demonstrated clinical improvement 5 to 10 min after glucagon administration, which was consistent with its peak clinical action. Beta-blockers, calcium channel blockers, and digoxin were ultimately thought to have contributed to the majority of these presentations. This report suggests that glucagon may have a role in the treatment of symptomatic bradycardia, particularly in the presence of beta-adrenergic blockade and perhaps calcium channel blockade. Furthermore, the results in these cases suggest that future clinical trials should not be limited to drug-induced symptomatic bradycardia.
Department of Emergency Medicine, Georgetown University Hospital, Washington, DC 20007, USA.
J N
JN
Love
D K
DK
Sachdeva
E S
ES
Bessman
L A
LA
Curtis
J M
JM
Howell
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001285:Atropine / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D001919:Bradycardia / Q000139:chemically induced / Q000188:drug therapy*; D002121:Calcium Channel Blockers / Q000009:adverse effects; D002986:Clinical Trials as Topic; D004077:Digoxin / Q000009:adverse effects; D005260:Female; D005934:Glucagon / Q000008:administration & dosage / Q000627:therapeutic use*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D002121:Calcium Channel Blockers; D004077:Digoxin; D001285:Atropine; D005934:Glucagon