PMID- 23653171
OWN - NLM
STAT- MEDLINE
DCOM- 20150212
LR  - 20211021
IS  - 1573-742X (Electronic)
IS  - 0929-5305 (Linking)
VI  - 37
IP  - 3
DP  - 2014 Apr
TI  - A 1-year drug utilization evaluation of protamine in hospitalized patients to 
      identify possible future roles of heparin and low molecular weight heparin 
      reversal agents.
PG  - 271-8
LID - 10.1007/s11239-013-0927-7 [doi]
AB  - Despite widespread use of unfractionated heparin (UFH) and low molecular weight 
      heparin (LMWH), protamine sulfate remains the only reversal agent for UFH that is 
      approved by the Food and Drug Administration within the US. Availability of new 
      reversal agents for approved anticoagulants and those in development may improve 
      patient safety and care. Delparantag (PMX-60056) is a novel small molecule that 
      shows ability to neutralize the anticoagulation effects of UFH and LMWH in 
      animals and humans. This study examined the 1-year utilization of protamine 
      within an acute care hospital in order to determine the need for a novel 
      reversing agent like delparantag. All patients having documented protamine 
      administration within a 1-year period were included. Pharmacy automated 
      dispensing machines and computerized medication management systems were queried 
      for all doses of protamine withdrawn, billed for, or dispensed. Scanned medical 
      records were reviewed and protamine and anticoagulant information was abstracted. 
      Primary procedural group categorizations for protamine patients were coronary 
      artery bypass graft, cardiac valve surgeries, abdominal aortic aneurysm and other 
      open abdominal surgeries, fistula placement, non-cardiac vascular, cardiac 
      catheter and electrophysiology lab, and "other." Average doses of protamine 
      administered were 439, 423, 126, 26, 46, 36, and 35 mg in these groups, 
      respectively. Four major bleeds and one serious adverse event occurred over the 
      year period. Protamine is used in a wide array of procedures. Evaluating 
      protamine's current use may be beneficial in identifying roles for future UFH and 
      LMWH reversal agent use.
FAU - Mahan, Charles E
AU  - Mahan CE
AD  - Presbyterian Healthcare Services, University of New Mexico, 1100 Central Ave. SE, 
      Albuquerque, NM, 87106, USA, chmahan@yahoo.com.
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - J Thromb Thrombolysis
JT  - Journal of thrombosis and thrombolysis
JID - 9502018
RN  - 0 (Heparin Antagonists)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Protamines)
SB  - IM
MH  - Animals
MH  - Cardiovascular Diseases/*therapy
MH  - Heparin Antagonists/*administration & dosage
MH  - Heparin, Low-Molecular-Weight/administration & dosage/adverse effects
MH  - Humans
MH  - Male
MH  - Medication Systems, Hospital
MH  - Protamines/*administration & dosage
MH  - Retrospective Studies
EDAT- 2013/05/09 06:00
MHDA- 2015/02/13 06:00
CRDT- 2013/05/09 06:00
PHST- 2013/05/09 06:00 [entrez]
PHST- 2013/05/09 06:00 [pubmed]
PHST- 2015/02/13 06:00 [medline]
AID - 10.1007/s11239-013-0927-7 [doi]
PST - ppublish
SO  - J Thromb Thrombolysis. 2014 Apr;37(3):271-8. doi: 10.1007/s11239-013-0927-7.