What is the antidote for low molecular weight heparin (LMWH) overdose?

The antidote for low molecular weight heparin (LMWH) overdose is intravenous protamine sulphate. Protamine is a specific antagonist to heparin, including both unfractionated heparin and low molecular weight heparin, as it binds to the heparin molecules and neutralizes their anticoagulant effects. This binding mechanism is crucial in clinical settings where rapid reversal of anticoagulation is necessary, such as in cases of bleeding or prior to surgical procedures.

While other options listed may have their uses in different medical contexts, they do not specifically counteract the effects of LMWH. For instance, intravenous vitamin K is utilized for reversing anticoagulation effects of vitamin K antagonists like warfarin, not heparins. Oral activated charcoal is used for the management of certain types of poisonings or drug overdoses but would not effectively reverse heparin effects, especially if the heparin has already been administered. Intravenous calcium gluconate is typically used in cases of hyperkalemia or calcium channel blocker overdose and does not have a role in reversing anticoagulation.

Choosing protamine sulphate aligns with evidence-based practices for managing LMWH overdose and ensures safe clinical outcomes in patients requiring reversal of antico