Cardiovascular Drugs and Medications Q 55
Which drug is used to stop bleeding associated with heparin overdose?
A. urokinase (Abbokinase).
B. aminocaproic acid (Amicar).
C. protamine sulfate (Protamine).
D. vitamin K (AquaMEPHYTON).
Correct Answer: C. protamine sulfate (Protamine).
Protamine is the drug used to reverse the adverse effects of bleeding that occurs with heparin administration. When heparin toxicity occurs, protamine is recommended for reversal of heparin’s anticoagulant effect. Patients with life-threatening or severe bleeding or patients who undergo surgery may require protamine for reversal. Neutralization of heparin occurs when protamine binds to the heparin by ionic properties. The protamine-heparin complex is inactive, and heparin is unable to act as an anticoagulant. Protamine administration should be via slow IV push with no more than 50 mg over 10 minutes.
Option A: Urokinase has been used most often for occluded catheters and peripheral vascular thrombosis. It is considered a physiologic thrombolytic that is usually produced by renal parenchyma, thus purified from human urine. However, recombinant urokinase is also commercially available. In contrast to streptokinase, urokinase directly cleaves plasminogen into plasmin. Its low antigenicity allows repeated dosing without antigenic problems.
Option B: Aminocaproic acid has received approval from the Food and Drug Administration (FDA) for the therapeutic management of acute hemorrhages caused by elevated fibrinolytic activity leading to surgical complications after cardiac surgery, hematological disorders, hepatic cirrhosis, and neoplastic disease. Indications also include the treatment of surgical and non-surgical hematuria.
Option D: Vitamin K is a fat-soluble vitamin that affects coagulation pathways within the body. Vitamin K is found in foods and can be a dietary supplement. Vitamin K is essential for the synthesis of coagulation proteins. It is a cofactor for vitamin K-dependent carboxylation, which includes various enzymes.