Protamine is a drug that reverses the anticoagulant effects of heparin by binding to it. Protamine is isolated from the sperm of various fish. An anticoagulant is a substance that prevents coagulation; that is, it stops blood from clotting. ... Heparin is an injectable anticoagulant, nowadays usually made synthetically. ...
Protamine sulfate is indicated in the treatment of heparin overdosage.
Protamine sulfate is intended for injection without further dilution; however, if further dilution is desired, D5-W or normal saline may be used.
Protamine sulfate should not be mixed with other drugs without knowledge of their compatibility, because protamine sulfate has been shown to be incompatible with certain antibiotics, including several of the cephalosporins and penicillins.
Excess protamine weakens clot structure and decreases platelet function; therefore, an increased activated clotting time (ACT) after protamine reversal of heparin may be misinterpreted as residual heparinanticoagulation.
Protamine to heparin ratios >1.3:1 produced a significant prolongation of the ACT that was not seen with rPF4 and was observed only with 5:1 hexadimethrine to heparin ratios.
Excessive protamine reversal of heparin prolongs ACT and alters ADP-induced platelet aggregation in a dose-dependent manner in vitro.
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