Protamine
Pharmacology
- Reverses Effects of Heparin
Adverse Effects
Anaphylaxis (see Anaphylaxis)
- Epidemiology
- In 50% of cases, there has been a prior exposure to protamine (either with protamine to reverse heparin or to protamine zinc insulin)
- Diagnosis
- Swan: increased PA pressures with normal PCWP
- Skin Testing: confirms sensitivity to protamine
- Clinical
Treatment
- Avoid use of protamine -> may use alternative hexadimethrine instead
- Vasoconstrictors: alpha agonists
- Corticosteroids
- Mechanical ventilation (as required) and other supportive care
References