Protamine Sulfate (Last Updated - 3/14/2005)

-heparin antidote
-used in pts. with life-threatening bleeds who are on heparin tx

-Mechanism:
     -reverses effex by binding & neutralizing heparin

-Dosing / Admin:
     -1 mg/100 units of heparin remaining in pt. @ slow IV rate of 50 mg/10mins

-Cautions:
     -anaphylaxis in ~1% of diabetics on protamine-containing insulin:
          -Ex.) NPH or protamine-zinc insulin

-Side Effex:
     A) pulmonary vasoconstriction
     B) RV dysfunction
     C) systemic hypotension
     D) transient neutropenia

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References:

Goodman & Gilman's: The Pharmacologic Basis Of Therapeutics - 10th Edition - 2001. Chapter 55.