What is a drug like protamine sulfate? Instructions for its use, as well as the form and indications of this tool will be indicated below.
Composition, description, form
What is protamine sulfate? This solution is available in the form of a yellowish or colorless transparent liquid, intended for intravenous administration. A drug based on this medicinal substance is of the same name and additionally contains water for injection.
“Protamine sulfate” is sold in ampoules, which are placed in the contour cells of polyvinyl chloride film, which are packaged in cardboard boxes. The packaging also contains instructions for use and an ampoule knife.
Drug action
What is protamine sulfate? The instruction reports that it is a heparin antagonist (specific). 1 mg of this substance can neutralize about 80-115 PIECES of heparin in the patient’s blood.
The action of the drug in question after intravenous injection occurs instantly and lasts about two hours. The complexation of this drug is due to the abundance of cationic groups that bind to the anionic centers of heparin.
According to the instructions of protamine sulfate in the human body forms a protamine-heparin complex, which is destroyed with the release of the latter.
In case of an overdose of this agent, the coagulability of the blood can significantly decrease in the patient, since the active substance of the drug in question exhibits high anticoagulant activity.
Pharmacokinetics
What kinetic properties does heparin protamine sulfate have? According to experts, the pharmacokinetic characteristics of this drug have not been investigated. Therefore, they are not presented in the instructions.
Indications for the appointment of a solution
In what cases can a patient be prescribed an intravenous solution of Protamine Sulfate? The use of this tool is shown:
- before surgery in people taking heparin for therapeutic purposes;
- with hyperheparinemia;
- with bleeding resulting from an overdose of heparin;
- after surgery on the blood vessels and heart with extracorporeal circulation.
Prohibitions for the appointment of a solution
The drug "Protamine sulfate" (the prescription for its purchase should be prescribed only by a doctor) is contraindicated for use in the following cases:
- with thrombocytopenia;
- high sensitivity to the elements of the drug;
- severe arterial hypotension;
- congenital or idiopathic hyperheparinemia (in this condition, the medication is ineffective, and can also significantly increase bleeding);
- taking insulin and other medicines containing protamine sulfate;
- allergic reactions to fish products, including a history of;
- adrenal insufficiency.
We can not say that the experience of medical use of this drug in children is limited.
During pregnancy and feeding, Protamine Sulfate can be used. However, this should only be done if the expected effect of the treatment significantly exceeds the probable risk to the fetus or child.
The drug "Protamine sulfate": instructions for use
The solution in question should be administered slowly intravenously drip or stream. In this case, the rate of administration should not be higher than 5 mg of the drug per minute. Faster drug administration can cause an anaphylactoid reaction in a patient .
The dosage of this medication depends on the route of administration. The calculated dose should be dissolved in 300-500 ml of 0.9% sodium chloride solution. It is strictly forbidden to administer more than 150 mg of the drug for 60 minutes.
- With bolus injections, the dosage of protamine sulfate decreases depending on the time that has passed since the administration of heparin. This is due to the fact that the latter is continuously removed from the human body.
- If heparin is administered intravenously, it is necessary to stop its infusion and use about 20-30 mg of protamine sulfate.
- When injected subcutaneously with heparin, the dosage of protamine sulfate is 1-1.5 mg per 100 IU of heparin. In this case, the first 25-50 mg must be administered slowly intravenously, and the remaining amount is drip intravenously for 8-17 hours. Fractional administration is also possible, but this will require strict control of the APTT.
- With surgical intervention in the case of extracorporeal circulation, the dosage of the solution in question is 1.5 mg per 100 IU of heparin.
The maximum duration of therapy with the drug in question is 3 days.
Side effect
Can protamine sulfate cause adverse reactions? The manual states that in general, this drug is relatively well tolerated by patients. However, in some cases, it can still cause negative effects on the part of the immune, cardiovascular and digestive systems, as well as the skin:
- bradycardia, decreased blood pressure;
- vomiting and nausea;
- itching, skin rash, the development of anaphylactoid reactions;
- a feeling of heat, a feeling of lack of air and hyperemia of the skin.
Cases of overdose and interaction with other drugs
The considered solution intended for intravenous administration is incompatible with penicillins and cephalosporins. Due to the fact that it is an antagonist of low molecular weight heparins, this medication can increase the duration and intensity of the action of non-depolarizing muscle relaxants.
An overdose of the drug may be accompanied by bleeding. This is due to the fact that the substance in question has a high anticoagulant activity. In this case, symptomatic treatment is required.
Special information
What should I know before introducing a solution such as protamine sulfate? Experts argue that the use of this drug should be strictly monitored by a doctor who is required to regularly monitor the patient's blood coagulation.
Before the introduction of this medication, it is necessary to verify the adequate blood volume of the patient. This is due to the fact that hypovolemia significantly increases the risk of collapse.
Storage conditions, dispensing from pharmacies, expiration date
Is the drug “Protamine sulfate” freely sold in pharmacies? The prescription in Latin or Russian should be presented to the pharmacist, otherwise the medication will not be released.
Keep the product in question out of the reach of children and protected from sunlight, where the air temperature is from 4 to 10 degrees. It should also be noted that the intravenous solution of "Protamine sulfate" in no case should be frozen.
The shelf life of this medication is 4 years from the date of manufacture. Do not use it after this period.
Analogues of the drug and reviews about it
There are not very many analogues in this tool. An intravenous solution can be replaced with drugs such as Protamine and Protamine-Ferein.
As for consumer reviews, almost all of them are positive. "Protamine sulfate" is a very effective and effective tool available to everyone. This is the opinion most patients adhere to. They argue that this medication does not allow heparin to inhibit the process of blood coagulation, improving the patient's condition with severe bleeding.
Also, the advantages of this medicinal substance include its quick and lasting effect. In addition, to achieve a therapeutic effect, the patient does not need to conduct long-term treatment. The maximum period of use of this drug is three days.