Heparin Antidote — NDEB AFK MCQ
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Correct answer: E — Protamine sulfate
Protamine sulfate is the specific antidote for heparin (unfractionated) overdose. Protamine is a positively charged protein that binds to negatively charged heparin molecules, forming a stable complex that neutralises heparin's anticoagulant activity. The dose is calculated based on the amount of heparin administered (1 mg protamine neutralises approximately 100 units of heparin). Vitamin K reverses warfarin (not heparin). Protamine only partially reverses LMWH (enoxaparin). Andexanet alfa reverses factor Xa inhibitors (rivaroxaban, apixaban).
Reference: Katzung – Basic and Clinical Pharmacology, 15th ed., 2021