Paper describes drugs necessary for adequate pre-hospital treatment that are not available to the physicians due to administrative barriers. However, innovations are not followed by changes within the lists of medications set by National Health Insurance Fund of Serbia (NHIFS). Modern protocols for treatment of injured and ill patients are introduced, demanding more and more knowledge and skills as well as more modern equipment and wider spectrum of drugs. This urgent approach progresses as fast as the science in medicine does.

The evidence supporting the use of glucagon in the management of patients with beta-blocker and calcium channel blocker overdoses is limited to animal studies.Įmergency Medicine does not represent a simple collection of various medical conditions, but rather an urgent approach to life threatening conditions.

The included studies for both overdoses were not blinded, had limited numbers of animals, and some had inadequate glucagon regime. Glucagon appeared to have no effect on survival rate. There appeared to be no effect of glucagon on mean arterial pressure although it did increase in one model. In the six studies of animal models of calcium channel blocker overdose included, glucagon appeared to increase heart rate and cardiac output and reverse second and third degree AV blocks, all at least transiently.

Its effect on the survival rate in animal models of beta-blocker overdose was unclear. In the five studies of animal models of beta-blocker overdose included, glucagon appeared to consistently increase the heart rate at least transiently but appeared to have no effect on mean arterial pressure even though it possibly increased cardiac output. The search found no study in humans but identified 30 in animals. The quality of the included studies was assessed. Only controlled studies of human or animal studies were included, the latter only when it was an in vivo model of acute poisoning. Studies evaluating glucagon for those uses were identified using the Cochrane Database of Systematic Reviews, the Cochrane Controlled Trials Register, MedLine, ToxLine, and EMBASE searches, as well as reviewing medical toxicology textbooks and references of identified articles. Glucagon is usually accepted as part of the standard treatment in the management of patients with beta-blocker and calcium channel blocker overdoses.Ī systematic review was done in order to evaluate the evidence supporting glucagon use in beta-blocker and calcium channel blocker overdoses.

Glucagon as beta blocker antidote