Protamine sulfate

Protamine Sulfate is a medication primarily used to reverse the effects of heparin, a type of anticoagulant. It is a highly cationic peptide obtained from the sperm of fish, particularly salmon. Protamine sulfate is used in medicine to neutralize the anticoagulant effect of heparin following cardiothoracic surgery. It is also used in the formulation of certain types of insulin and to manufacture certain types of vaccines.

Pharmacology

Protamine sulfate works by binding to heparin to form a stable complex, thereby neutralizing its anticoagulant effect. It is a strong base and its positive charges interact with the negative charges of heparin, leading to the inactivation of the anticoagulant properties of heparin.

Clinical Uses

Protamine sulfate is used in a variety of clinical settings. Its primary use is to reverse the effects of heparin, which is often used during procedures that require blood thinning, such as cardiovascular surgery. It is also used in the formulation of certain types of insulin, including NPH insulin and insulin lispro protamine. In addition, protamine sulfate is used in the manufacturing process of certain vaccines.

Side Effects

While protamine sulfate is generally well-tolerated, it can cause side effects in some individuals. These can include hypotension, bradycardia, pulmonary hypertension, and allergic reactions. In rare cases, it can cause catastrophic pulmonary vasoconstriction leading to severe pulmonary hypertension, right heart failure and potentially death.

Contraindications

Protamine sulfate should not be used in patients with a known allergy to it. It should also be used with caution in patients with a history of vasectomy, as these individuals may have developed antibodies to protamine.

See Also

• Heparin
• Anticoagulant
• Insulin
• Vaccine