Instruction for use: Protamine sulfate

Trade name of the drug – Protamine, Protamine-Ferein, Protamine sulfate

The Latin name of the substance Protamine sulfate

Protamini sulfas (genus. Protamini sulfatis)

Pharmacological group:

Coagulants (including coagulation factors), hemostatics

The nosological classification (ICD-10)

T45.5 Antikoagulant poisoning: Overdose of heparin; Overdose of neodikumarina; Overdose of anticoagulants coumarinic and indanedione; Overdose of anticoagulants of indirect action; Overdose of indirect anticoagulants; An overdose of anticoagulants; Overdose of anticoagulants or fibrinolytics

Z100 * CLASS XXII Surgical practice: Abdominal surgery; adenomectomy; Amputation; Coronary angioplasty; Angioplasty of the carotid arteries; Antiseptic skin treatment for wounds; Antiseptic Hand; Appendectomy; atherectomy; Balloon coronary angioplasty; Vaginal hysterectomy; The coronary bypass; Interventions in the vagina and cervix; Interventions on the bladder; Intervention in the mouth; Restoration and reconstructive surgery; Hand hygiene of medical personnel; Gynecologic surgery; Gynecological intervention; Gynecological surgery; Hypovolemic shock during operations; Disinfection of purulent wounds; Disinfection of wounds edges; Diagnostic intervention; Diagnostic procedures; Cervical Diathermocoagulation; Long-surgery; Replacing the fistula catheters; Infection in orthopedic surgery; Artificial heart valve; cystectomy; Short-term outpatient surgery; Short-term operation; Short surgical procedures; Krikotireotomiya; Blood loss during surgery; Bleeding during surgery and in the postoperative period; Kuldotsentez; laser photocoagulation; laser coagulation; retinal laser coagulation; Laparoscopy; Laparoscopy in Gynecology; CSF fistula; Small gynecological operations; Small surgical procedures; Mastectomy and subsequent plastic; mediastinotomy; Microsurgical operations on the ear; Mukogingivalnye operation; suturing; Minor surgery; neurosurgical operation; Immobilization of the eyeball in ophthalmic surgery; testectomy; pancreatectomy; Perikardektomiya; The period of rehabilitation after surgery; The period of convalescence after surgery; Percutaneous transluminal coronary angioplasty; Pleural thoracentesis; Pneumonia postoperative and posttraumatic; Preparation for surgical procedures; Preparation for surgery; Preparation of the surgeon's hands before surgery; Preparation of the colon for surgical procedures; Postoperative aspiration pneumonia in neurosurgical and thoracic surgery; Postoperative nausea; Postoperative bleeding; postoperative granuloma; postoperative shock; The early postoperative period; myocardial revascularization; Radiectomy; gastric Resection; bowel resection; uterine Resection; liver Resection; enterectomy; Resection of part of the stomach; Reocclusion of the operated vessel; Bonding tissues during surgical procedures; Removal of sutures; Condition after eye surgery; Condition after surgery; Condition after surgery in the nasal cavity; Condition after gastrectomy; Status after resection of the small intestine; Condition after tonsillectomy; Condition after removal of the duodenum; Condition after phlebectomy; Vascular surgery; Splenectomy; Sterilization of surgical instruments; Sterilization of surgical instruments; sternotomy; Dental surgery; Dental intervention in periodontal tissues; strumectomy; Tonsillectomy; Thoracic surgery; Thoracic surgery; total gastrectomy; Transdermal intravascular coronary angioplasty; Transurethral resection; Turbinektomiya; Removal of a tooth; cataract surgery; Removal of cysts; tonsillectomy; Removal of fibroids; Removing the mobile primary teeth; Removing polyps; Removing broken tooth; Removal of the uterus body; Removal of sutures; Fistula likvoroprovodyaschih ways; Frontoetmoidogaymorotomiya; Surgical infection; Surgical treatment of chronic limb ulcers; Surgery; The surgery in the anal area; The surgery on the colon; Surgical practice; The surgical procedure; Surgical interventions; Surgery on the gastrointestinal tract; Surgical procedures on the urinary tract; Surgical procedures on the urinary system; Surgical intervention of the genitourinary system; Surgical procedures on the heart; Surgical manipulation; surgery; Surgery on the veins; Surgical intervention; Vascular surgery; Surgical treatment of thrombosis; Surgery; cholecystectomy; Partial gastric resection; hysterectomy; Percutaneous transluminal coronary angioplasty; Percutaneous transluminal angioplasty; Coronary artery bypass; tooth Extirpation; Extirpation of milk teeth; pulpectomy; pulsative cardiopulmonary bypass; tooth Extraction; teeth Extraction; cataract extraction; Electrocoagulation; endourological intervention; episiotomy; Etmoidotomiya; Complications after tooth extraction

Characteristics of the substance Protamine sulfate

A white, fine-grained or off-white amorphous or crystalline powder, sparingly soluble in water.

Pharmacology

Mode action - Hemostatic.

Neutralizes the action of heparin, has a hemostatic and weak anticoagulant properties. It forms stable complexes with heparin, and the ability of heparin to inhibit coagulability of the blood disappears. Complexation is due to the abundance of cationic groups (due to arginine), which bind to the anionic centers of heparin. Effective with some types of hemorrhages associated with heparin-like disorders of blood coagulation. The effect develops instantly ("on the needle") and lasts 2 hours.

Application of the substance Protamine sulfate

Bleeding caused by an overdose of heparin, before surgery against a background of heparin therapy, after operations on the heart and blood vessels with extracorporeal circulation.

Contraindications

Hypersensitivity, idiopathic and congenital hyperheparinemia, pronounced hypotension, thrombocytopenia, insufficiency of the adrenal cortex.

Side effects of Protamine sulfate

Bradycardia, hypertension / hypotension, sensation of fever, agitation, allergic reactions.

Interaction

Incompatible with cephalosporins and penicillins.

Overdose

Can be accompanied by bleeding, tk. Protamine has its own anticoagulant activity.

Routes of administration

IV.

Precautions for Protamine sulfate

During the treatment, it is necessary to monitor the coagulability of the blood. Before the introduction should be made sure the adequacy of the patient's blood volume (hypovolemia increases the risk of collapse).