ALS MONITOR MEDICATION

Heparin & Protamine Sulfate

  1. Therapeutic Effects
    Heparin
  1. Potent parenteral anticoagulant.

    Protamine
  1. Interacts with Heparin to cease the effects of Heparin.

  • Indications
      Heparin
    1. Deep venous thrombosis.
    2. Disseminated intravascular coagulopathy.
    3. Pulmonary embolism.
    4. Vascular or cariovascular surgery.
    5. Coronary event prophilaxis.

      Protamine
    1. Treatment of Heparin overdosage.

  • Contraindications/Precautions
      Heparin
    1. Recent neurotrauma or surgery; intraocular surgery, thrombocytopenia, coagulation disorder or sensitivity to pork or beef heparin preparations.

      Protamine
    1. Patients with previous intolerance to the drug.

  • Side Effects
      Heparin
    1. Hemorrhage is the most common.
    2. Thrombocytopenia
    3. Transient hypotension with bolus therapy.
    4. Allergic reaction.
    5. Overdose.

      Protamine
    1. Heparin rebound.
    2. Hypotension.
    3. Nausea/vomiting.
    4. Anaphylaxis.

  • Administration and Dosage
      Heparin
      Variable
    1. SQ route-5,000 USP U loading dose followed by 5,000 USP U q8-12 hrs.
    2. IV route-100 USP U/kg IV followed by 800-1,200 USP U/hr.

      Protamine
    1. 1 mg neutralizes approximately 90 USP U of Heparin. Protamine dose required decreases rapidly with time.
    2. Protamine should be administered slow IV push over 1-3 min.
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