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Protamine sulfate is a medication that is used to reverse the effects of heparin. [3] It is specifically used in heparin overdose , in low molecular weight heparin overdose , and to reverse the effects of heparin during delivery and heart surgery .
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 .
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.
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 ]
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Because protamine is a fast-acting drug, it is typically given slowly to allow for monitoring of possible reactions. [12] 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 ...