Glucagon delivery method

[Mango Juice]

Hi all!

Like a few others, I have also changed my name; I was not a frequent poster, but I wonder if anyone will figure it out between organizing bandaids and handing out saltines.

Anyway, here is my question:

Does anyone know why glucagon comes the way it does? Why is it not packaged in a dual chamber vial? Or some kind of carpuject that allows for the sterile solution not to be mixed with the powder until it needs to be administered?

I feel like it should be since it is intended to be given by lay people who are most likely intimidated by the current process.

Besides patenting and financing, can anyone figure out why it is not more intuitive and user-friendly?

Thank you and HAPPY ALMOST WEEKEND!!!

[OldDude]

You're Nurse Barb G???????? JK - I have no data to reference but my feeling is that it is so seldom used that it wouldn't be economical to mass produce that type of delivery system. I know there are exceptions, yadda yadda, but I've never administered it and I don't know anyone that has either.

[chare]

It's unstable in solution, and should be reconstituted immediately prior to use.

Glucagon: Physiology and Pharmacotherapy: Stabilized Glucagon Formulation for Bihormonal Pump Use

[OldDude]

I get that but Mango is talking about something like the SoluMedrol containters where you press the top, the med gets mixed, and bam, draw it up to admin.

[ruby_jane, BSN, RN]

I agree with OD....there's no impetus for better technology (even if there is need).... I don't know if any of the unlicensed assistant personnel would ever be comfortable in an emergency. I take expired pens and we practice sometimes, though.

[KKEGS, MSN, RN]

We were JUST having this conversation in my health office the other week! I'm curious to hear what other people have to say because, I agree, it is a dumb system considering it's for lay people. We figured out how to make an EpiPen easy. Why not glucagon?

[BluebellRN, BSN, RN]

No time like the present to come out of lurking :)

I'm a new school nurse this year, and have been hanging out here soaking up all the wisdom.

As for the glucagon; it's in the works and they have already done human trials.

Xeris Pharmaceuticals Announces New Results From Ready-To-Use Liquid Glucagon Clinical Development Program

[cooties_are_real]

Just sitting her thinking about using causes me to shudder. Epi-pen is easy concept, but all steps you have to do for the glucagon just gives me anxiety. Never had to use one or come close. Would love to hear from some one who has had to use one.

I just pray if I ever need to use one my hands and brain will be steady.

[OldDude]

I agree with OD....there's no impetus for better technology (even if there is need).... I don't know if any of the unlicensed assistant personnel would ever be comfortable in an emergency. I take expired pens and we practice sometimes, though.

regarding expired epipens...I will get a teacher who has a highly allergic student in their class to "fire" the epipen. I get a cardboard box with no top (so you can see into it). I hold the box and let the teacher stick the side of the box to see how explosive the medicine delivery is when it splashes the med on the opposite box wall. They all "jump" when it engages but they get the picture.

[kunaspud]

I have used it in my prior job, many times. Same thing as the epi pen, when the adrenaline kicks in, it all works out. The hardest part is waiting the fifteen minutes to retest.

[MrNurse(x2), ADN]

No time like the present to come out of lurking :)

I'm a new school nurse this year, and have been hanging out here soaking up all the wisdom.

As for the glucagon; it's in the works and they have already done human trials.

Xeris Pharmaceuticals Announces New Results From Ready-To-Use Liquid Glucagon Clinical Development Program

Welcome! You may be new, but I am sure you have things to contribute. Wear pink on Wednesdays, unless you want to sit with OD and me. Pull up a chair and join us.

[JenTheSchoolRN, BSN, RN]

regarding expired epipens...I will get a teacher who has a highly allergic student in their class to "fire" the epipen. I get a cardboard box with no top (so you can see into it). I hold the box and let the teacher stick the side of the box to see how explosive the medicine delivery is when it splashes the med on the opposite box wall. They all "jump" when it engages but they get the picture.

I used this OD trick when I did Epipen training for the staff at my school this year. I wanted to show them how an actual Epipen "fired." They jumped, but loved seeing it action. Also very much proves that Epipens will go through clothing with no problem!

As for glucagon - I actually cannot delegate this to a lay person unless I have trained them extensively and parent has signed off on that specific person. And to be honest, most parents I have worked with a student with diabetes prefer I do NOT send glucagon on field trips and have teacher call 911 (99% of our field trips are easy access for quick medical care) because the mixing glucagon can be more complicated. They are fine with me giving it if needed at school.

(Additionally - I do not know of any my diabetic students who carry glucagon on them all the time, what happens if they need it when they aren't at school?)

And personally, I have never given it. Has anyone on this board given it in a school setting? I'm very curious.