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Hypotension protamine

Protamine sulfate can result in severe hypotension and anaphylactic reaction. When administering protamine sulfate, the nurse should make sure that resuscitation equipment is readily available. [Pg.428]

When given rapidly, protamine causes hypotension due to a decrease in vascular resistance, possibly linked to the release of nitric oxide from endothelium. Flypotension can be minimised by slow administration over 10-15 minutes. Protamine does not affect myocardial contractility. In some patients, systemic hypotension occurs in conjunction with pulmonary hypertension and, in severe cases, right ventricular failure. The mechanism is activation of the complement pathways by the heparin-protamine complex leading to release of thromboxane A2, which mediates pulmonary vasoconstriction. Unlike in anaphylaxis, plasma histamine concentrations are not increased. When this syndrome develops protamine administration should be stopped, and some have recommended giving heparin in an attempt to reduce the size of the heparin-protamine complex. [Pg.259]

Too rapid of an administration of protamine can have serious side effects, including hypotension and anaphylaxis. Pulmonary hypertension, shortness of breath, flushing, and urticaria have all been associated with rapid administration. Patients with allergies to fish products may be allergic to protamine. [Pg.570]

The precise mechanisms that explain protamine-mediated systemic hypotension are unknown, but there is evidence that it may be mediated by the endothelium and dependent on nitric oxide/cyclic guanosine monophosphate it has been suggested that methylthioninium chloride (methylene blue) may be of use in treating hemodynamic complications caused by the use of protamine after cardiopulmonary bypass (4). [Pg.2964]

Anaphylactic reactions occur in 1% of patients with diabetes mellitus who have received protamine-containing insulin NPFl insulin or protamine zinc insulin) but are not limited to this group. A less common reaction consisting of pulmonary vasoconstriction, right ventricular dysfunction, systemic hypotension, and transient neutropenia also may occur after protamine administration. [Pg.954]

Because of hemorrhage risk, check hematocrit and test for blood in stool. Administer with caution to menstruating women, or patients with subacute bacterial endocarditis, severe hypotension, liver disease, or blood dyscrasias. Protamine sulfate inactivates heparin and can be used as an antagonist if severe bleeding occurs. [Pg.83]

Cardiovascular In 242 consecutive patients (mean age 58 years, 193 men) with drug refractory atrial fibrillation who underwent catheter ablation and received protamine immediately after catheter ablation to reverse the effects of heparin, 58 had prior exposure to protamine three developed an adverse reaction to protamine (1.2%), each with profound hypotension [212 ]. [Pg.727]

A 72-year-old man developed hypotension and generalized urticaria during protamine infusion after coronary artery bypass grafting [216 ]. There was no response to adrenaline, noradrenaline, vasopressin, diphenhydramine, hydrocortisone, calcium chloride, and crystalloid boluses, but 15 minutes after the administration of methylthioninium chloride 100 mg the blood pressure stabilized. [Pg.727]


See other pages where Hypotension protamine is mentioned: [Pg.215]    [Pg.2964]    [Pg.1313]    [Pg.64]    [Pg.1250]    [Pg.285]    [Pg.285]   
See also in sourсe #XX -- [ Pg.727 ]




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