Protamine Sulphate
Trade names: prosulf
Class: heparin antidote Pregnancy: (Category C) Action:
It binds to heparin to form a stable ion pair which does not
have anticoagulant activity.
Uses:
Protamine
sulfate is usually administered to reverse the large dose of heparin
administered during certain surgeries, especially heart surgery. It is also
used in gene transfer and protein purification.
Dose:
by intravenous
injection over approx. 10 minutes, 1 mg neutralises 80–100 units heparin when
given within 15 minutes of heparin; if longer time, less protamine required as
heparin rapidly excreted; max. 50 mg Contraindications:
Patients who have shown previous
intolerance to the drug.
Side effects:
I.V. injections of protamine may cause a
sudden fall in blood pressure, bradycardia, pulmonary hypertension, dyspnea, or
transitory flushing and a feeling of warmth. There have been reports of
anaphylaxis that resulted in respiratory embarrassment (see Precautions). Other
reported adverse reactions include systemic hypertension, nausea, vomiting and
lassitude. Back pain has been reported rarely in conscious patients undergoing
such procedures as cardiac catheterization.
Nursing
considerations:
If given too quickly, may cause a severe drop
in blood pressure and severe allergic reaction.
Facilities for resuscitation and treatment of
shock should be available.
Patients should be carefully monitored using
either the activated partial thromboplastin time or the activated coagulation
time, carried out 5-15 minutes after protamine sulphate administration.
