Which medications in the drug class Positive Inotropic Agents are used in the treatment of Anaphylaxis?

Updated: May 16, 2018
  • Author: S Shahzad Mustafa, MD; Chief Editor: Michael A Kaliner, MD  more...
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Answer

Positive Inotropic Agents

These agents help maintain blood pressure independent of adrenergic receptors by increasing intracellular levels of cyclic AMP. In addition, stimulate release of endogenous catecholamines.

Glucagon (GlucaGen)

Glucagon might be beneficial for severe anaphylaxis in patients taking beta-blockers (it should be used in addition to epinephrine, not as a substitute), although data are limited to case reports. Glucagon can also be used to reverse bronchospasm.

Pancreatic alpha cells of the islets of Langerhans produce glucagon, a polypeptide hormone. Glucagon exerts opposite effects of insulin on blood glucose. It elevates blood glucose levels by inhibiting glycogen synthesis and enhancing formation of glucose from noncarbohydrate sources, such as proteins and fats (gluconeogenesis). It increases hydrolysis of glycogen to glucose (glycogenolysis) in liver in addition to accelerating hepatic glycogenolysis and lipolysis in adipose tissue. It also increases force of contraction in the heart and has a relaxant effect on the GI tract.

The dose used for anaphylaxis is higher than the usual dose of 1 mg (1 U) IV/IM/SC used to treat hypoglycemia.


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