protamine
Pronunciation: PROH-tah-meen
Medication used to reverse heparin anticoagulation following cardiopulmonary bypass.
Full Definition
Protamine sulfate is a positively charged protein derived from salmon sperm that serves as the standard antidote for heparin reversal following cardiac surgery. During cardiopulmonary bypass, patients receive high-dose heparin for anticoagulation; protamine is administered at the conclusion of bypass to restore normal coagulation. The drug works by binding to the negatively charged heparin molecules, forming inactive complexes that are cleared from circulation. Protamine administration requires careful monitoring as it can cause severe allergic reactions, pulmonary hypertension, and myocardial depression. Dosing is typically calculated based on initial heparin dose and activated clotting time measurements.
Usage
Usage note: Essential drug in cardiac surgery but requires careful administration due to potential adverse reactions.
In Context
- "Protamine was administered slowly to reverse heparin following successful weaning from bypass." — Operative report
- "The patient developed mild hypotension during protamine administration." — Anesthesia record