Protamine-Induced Hypotension and Pulmonary Arterial Hypertension

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dc.contributor.authorChooriyil, Nidheeshen_US
dc.contributor.authorJom, Doyceen_US
dc.contributor.authorPanattil, Prabithaen_US
dc.contributor.authorSreedharan, Syamen_US
dc.date.accessioned2023-06-17T07:10:54Z
dc.date.available2023-06-17T07:10:54Z
dc.date.issued2021-03
dc.description.abstractProtamine is a routinely used safe antidote for heparin reversal in cardiovascular surgeries. Protamine was first introduced to prolong the action of insulin preparations. As protamine interacts with platelets and fibrinogen and has an anticoagulant effect of its own, minimal amount is given to neutralize heparin present in plasma. Although infrequent, protamine is associated with serious adverse drug reactions (ADRs), especially in patients with previous history of protamine hypersensitivity. Here, we report a case of protamine-induced pulmonary arterial hypertension and peripheral vascular collapse in a 60-year-old diabetic male patient who had undergone on-pump coronary artery bypass grafting in a tertiary care center. This was a definite, nonpreventable, severe ADR as per causality, preventability, and severity assessment scale. This patient had no previous history of protamine hypersensitivity and was not on any insulin preparations. Despite precise timely treatment and other resuscitative measures, the patient expired subsequent to these ADRs. This case report throws light on the grave requirement in urgent evolvement of pharmacogenetic and pharmacokinetic tools to detect patients who are at risk of precipitating these ADRs and thus to take precautions to prevent themen_US
dc.identifier.affiliationsDepartment of Cardiovascular and Thoracic Surgeryen_US
dc.identifier.affiliationsADR Monitoring Centreen_US
dc.identifier.affiliationsDepartment of Pharmacology, Government Medical College, Kottayam, Kerala, Indiaen_US
dc.identifier.citationChooriyil Nidheesh, Jom Doyce, Panattil Prabitha, Sreedharan Syam. Protamine-Induced Hypotension and Pulmonary Arterial Hypertension. Journal of Pharmacology and Pharmacotherapeutics . 2021 Mar; 12(1): 23-25en_US
dc.identifier.issn0976-500X
dc.identifier.issn0976-5018
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/215996
dc.languageenen_US
dc.publisherWolters Kluwer – Medknowen_US
dc.relation.issuenumber1en_US
dc.relation.volume12en_US
dc.source.urihttps://doi.org/10.4103/jpp.JPP_157_20en_US
dc.subjectAdverse drug reactionsen_US
dc.subjectheparin reversalen_US
dc.subjecton-pump coronary artery bypass graftingen_US
dc.titleProtamine-Induced Hypotension and Pulmonary Arterial Hypertensionen_US
dc.typeJournal Articleen_US
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