Which of the following patients is most likely to be treated with intravenous glucagon?
**Core Concept**
Glucagon is a hormone produced by the pancreas that plays a crucial role in glucose homeostasis by stimulating glycogenolysis and gluconeogenesis. Intravenous glucagon is used in the treatment of hypoglycemia, particularly in patients with diabetes who are unable to produce adequate amounts of endogenous glucagon.
**Why the Correct Answer is Right**
Intravenous glucagon is the treatment of choice for severe hypoglycemia, especially in patients with diabetes who are unable to respond to oral glucose or intravenous glucose solutions. Glucagon stimulates the liver to release stored glycogen, which is then converted to glucose and released into the bloodstream to raise blood glucose levels. This is particularly useful in patients who are unconscious or unable to take oral medication. The use of intravenous glucagon is also beneficial because it bypasses the need for glucose to be absorbed from the gastrointestinal tract.
**Why Each Wrong Option is Incorrect**
**Option A:** **Nausea and vomiting are not indications for intravenous glucagon.** While glucagon can cause gastrointestinal side effects, its use is not warranted solely for these symptoms.
**Option B:** **Intravenous glucagon is not used for the treatment of hyperglycemia.** Glucagon actually increases blood glucose levels, so it would be contraindicated in patients with hyperglycemia.
**Option C:** **Intravenous glucose is the preferred treatment for mild to moderate hypoglycemia.** While intravenous glucose is a viable option for treating hypoglycemia, intravenous glucagon is preferred in severe cases or when oral glucose or intravenous glucose solutions are not feasible.
**Clinical Pearl / High-Yield Fact**
Glucagon is a valuable treatment option for severe hypoglycemia, particularly in patients with diabetes who are unable to respond to other treatments. It is essential to remember that glucagon should be administered intravenously in a controlled medical setting.
**Correct Answer: C. In a patient with severe hypoglycemia who is unable to take oral glucose.**