Tranexamic Acid

Tranexamic Acid

Tranexamic Acid
Class
	Antifibrinolytic, hemostatic agent
Action
	Inhibits plasminogen activation and plasmin activity Inhibits the breakdown of fibrin during bleeding episodes.
Indications
	Known or suspected hemorrhage after crush, blunt or penetrating trauma who is at high risk for ongoing internal hemorrhage meeting one or more of the following criteria: Systolic blood pressure less than 90 mm Hg. Patients over 65 years of age with systolic blood pressure less than 110 mm Hg. Tachycardia with heart rate greater than 120 beats per minute with signs of hypoperfusion present (confusion, altered mental status, cool extremities, etc.).
Contraindications
	Hemorrhagic shock from non-traumatic causes (e.g. GI bleeding) Injuries greater than 3 hours old. Hypersensitivity to the drug
Precaution
	Caution in patients with history of deep vein thrombosis (DVT), pulmonary embolus, other blood clots, or severe renal failure.
Side effects
	Anxiety, blurred vision, confusion, seizure. Hypotension, chest pain, tachycardia Nausea, vomiting, diarrhea Shortness of breath, cough
Administration
Rout: IV	Onset: 5-15 minutes	Peak effect: variable	Duration: 3 hours
Adult Dose:
	1gm/100 ml NS IV as soon as possible, but not >3 hours after injury Note: to prepare the dose, mix 1 gram TXA in 100 mL or 250 ML NS. Attach to administration set and infuse over 10 minutes.
Pediatric Dose:
	< 12 years old, administer 15 mg/kg (max 1 gm) in 100 ml NS IV as soon as possible, but not >3 hours after injury. > 12 years old, administer 1 gm/100 ml NS as soon as possible, but not >3 hours after injury.