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All protamine precipitated as the double salt of platinum and was free of sulfur and phosphorus. Protamine sulfate was originally made from the sperm of salmon. The protamine of salmon, later named “salmine”, which can be extracted with hydrochloric acid and precipitated with platinum chloride, corresponds to about 26.8 % of the dried sperm.
Protamine sulfate [51] Table 1: antidotes for cardiovascular agent overdose For patients taking antihyperlipidemic agents, liver function tests have to be conducted before and during the therapy to monitor the elevation of liver enzymes which may result in hepatotoxicity , especially for those undergoing statin therapy . [ 52 ]
Protamine sulfate is an antidote for heparin overdose, but severe allergy may occur. [10] A chain shortened version of protamine also acts as a potent heparin antagonist, but with markedly reduced antigenicity.
Protamine insulin was first created in 1936 and NPH insulin in 1946. [1] It is on the World Health Organization's List of Essential Medicines. [4] NPH is an abbreviation for "neutral protamine Hagedorn". [1] In 2020, insulin isophane was the 221st most commonly prescribed medication in the United States, with more than 2 million prescriptions.
Hepatin's anticoagulant effects are typically reversible with protamine sulfate, while protamine's effect on LMWH is limited. LMWH has less of an effect on thrombin than heparin, but about the same effect on Factor Xa. Due to its renal clearance, LMWH is contraindicated in patients with kidney disease who can safely use unfractionated heparin.
The first step in management of a protamine reaction is to immediately stop the protamine infusion. Corticosteroids are used for all types of protamine reactions. Chlorphenamine is used for type II (anaphylactic) reactions. For type III reactions, heparin is redosed and the patient may need to go back on bypass. [13]
[2] [3] Patients either view online patient education programs and materials in a medical office or from their homes or other remote locations with Internet access. Content may include interactive features such as quizzes, live question and answer sessions (in moderated web seminars), and the ability to complete and submit forms.
On the other hand, the use of milder conditions such as acetyl sulfate leads to incomplete sulfonation. Recently, the atom transfer radical polymerization (ATRP) of protected styrene sulfonates has been reported, [ 12 ] [ 13 ] leading to well defined linear polymers, as well as more complicated molecular architectures.