In pediatric glucagon dosing for hypoglycemia when IV access cannot be established, after how many minutes may a second dose be given?

• A. After 10 minutes
• B. After 20 minutes
• C. After 5 minutes
• D. After 30 minutes

Answer: (B)

This question tests the timing for giving a second glucagon dose when IV access cannot be established in a child with hypoglycemia. Glucagon given intramuscularly or subcutaneously works by mobilizing stored glucose, but its effect isn’t instantaneous. You give the first dose and then monitor for a response, allowing time for hepatic glycogen breakdown to raise the blood glucose.

If there’s no adequate improvement after about twenty minutes, a second dose is appropriate. This interval gives enough time for the initial dose to take effect while still acting quickly to correct the hypoglycemia. Waiting much longer risks ongoing hypoglycemia and potential harm, while giving a second dose too soon (in just a few minutes) may be premature since the first dose may still be working. Therefore, the correct approach is to administer a second dose after twenty minutes.