(2009), polyionic complexes (PICs) were prepared based on the ionic interaction between the polycation PS and the polyanion poly( l-aspartic acid) (PASP) for combined delivery of the anticancer drug, Dox, and plasmid DNA delivery. Protamine sulfate (PS), mainly composed of poly( l-arginine), is biodegradable and has been widely used for biomedical and biotechnological applications. Kamel, in Advances in Protein Chemistry and Structural Biology, 2015 3.8 Protamine The most severe reactions are attributed to immunoglobulin G or E antibodies to protamine. 94 The precise mechanism of adverse protamine reactions is not well elucidated, but is believed to involve mast cell activation, complement activation, and antiprotamine antibodies. In a study of 243 patients undergoing cardiac surgery who received protamine sulfate, 26 had immediate protamine reactions of these, 21 had previous protamine exposure (cardiac catheterization or surgery).
93 Vasectomy may also raise the risk of protamine-related events owing to the formation of antisperm antibodies via the exposure of blood to sperm (normally immunologically isolated in the testes). Previous exposure to protamine in this form or as neutral protamine Hagedorn (NPH) insulin predisposes patients to adverse reactions. The use of this agent is plagued by a multitude of adverse reactions ranging from mild rash to life-threatening cardiovascular collapse. In order to reverse heparin effects, one administers 1 mg of protamine per 100 units of heparin administered in the last 6 hours. Protamine sulfate is a small arginine-rich protein derived from salmon sperm nuclei.
Sidawy MD, MPH, in Rutherford's Vascular Surgery and Endovascular Therapy, 2019 Protamine Sulfate
administration concentration and rate.Īnton N. See aforementioned heparin antidote IV dosage for max. If aPTT remains prolonged 2–4 hr after the first protamine dose or if bleeding continues, a second infusion of 0.5 mg protamine per 1 mg enoxaparin may be given. If 12 hr: Protamine not required but if serious bleeding is present, give 50% of aforementioned dose. 1 mg protamine will neutralize 115 U porcine intestinal heparin, or 100 U (1 mg) low-molecular-weight heparin.
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