Brand name: Hemostan, Fibrinon, Cyklokapron, Lysteda, Transamin
Classification: Anti-fibrinolytic, antihemorrhagic
Indications:
Tranexamic acid is used for the prompt and effective control of hemorrhage in various surgical and clinical areas:
- Treating heavy menstrual bleeding
- Hemorrhage following dental and/or oral surgery in patients with hemophilia
- Management of hemophilic patients (those having Factor VIII or Factor IX deficiency) who have oral mucosal bleeding, or are undergoing tooth extraction or other oral surgical procedures.
- Surgical: General surgical cases but most especially operative procedures on the prostate, uterus, thyroid, lungs, heart, ovaries, adrenals, kidneys, brain, tonsils, lymph nodes and soft tissues.
- Obstetrical and gynecological: abortion, post-partum hemorrhage and menometrorrahgia
- Medical: epistaxis, hemoptysis, hematuria, peptic ulcer with hemorrhage and blood dyscrasias with hemorrhage
- Effective in promoting hemostasis in traumatic injuries.
- Preventing hemorrhage after orthopedic surgeries.
Mechanism of Action
Tranexamic acid is a synthetic derivative of the amino acid lysine. It exerts its antifibrinolytic effect through the reversible blockade of lysine-binding sites on plasminogen molecules. Anti-fibrinolytic drug inhibits endometrial plasminogen activator and thus prevents fibrinolysis and the breakdown of blood clots. The plasminogen-plasmin enzyme system is known to cause coagulation defects through lytic activity on fibrinogen, fibrin and other clotting factors. By inhibiting the action of plasmin (finronolysin) the anti-fibrinolytic agents reduce excessive breakdown of fibrin and effect physiological hemostasis.
Contraindications
- Allergic reaction to the drug or hypersensitivity
- Presence of blood clots (eg, in the leg, lung, eye, brain), have a history of blood clots, or are at risk for blood clots
- Current administration of factor IX complex concentrates or anti-inhibitor coagulant concentrates
Precautions
- Pregnancy. Tranexamic acid crosses the placenta.
- Lactation. Tranexamic acid is distributed into breast milk; concentrations reach approximately 1% of the maternal plasma concentration.
- Contraceptives, estrogen-containing, oral or Estrogens. Concurrent use with tranexamic acid may increase the potential for thrombus formation.
- Renal function impairment (medication may accumulate; dosage adjustment based on the degree of impairment is recommended)
- Hematuria of upper urinary tract origin (risk of intrarenal obstruction secondary to clot retention in the renal pelvis and ureters if hematuria is massive; also, if hematuria is associated with a disease of the renal parenchyma, intravascular precipitation of fibrin may occur and exacerbate the disease)
Nursing Responsibilities
- Unusual change in bleeding pattern should be immediately reported to the physician.
- For women who are taking Tranexamic acid to control heavy bleeding, the medication should only be taken during the menstrual period.
- Tranexamic Acid should be used with extreme caution in CHILDREN younger than 18 years old; safety and effectiveness in these children have not been confirmed.
- The medication can be taken with or without meals.
- Swallow Tranexamic Acid whole with plenty of liquids. Do not break, crush, or chew before swallowing.
- If you miss a dose of Tranexamic Acid, take it when you remember, then take your next dose at least 6 hours later. Do not take 2 doses at once.
- Inform the client that he/she should inform the physician immediately if the following severe side effects occur:
- Severe allergic reactions such as rash, hives, itching, dyspnea, tightness in the chest, swelling of the mouth, face, lips or tongue
- Calf pain, swelling or tenderness
- Chest pain
- Confusion
- Coughing up blood
- Decreased urination
- Severe or persistent headache
- Severe or persistent body malaise
- Shortness of breath
- Slurred speech
- Slurred speech
- Vision changes
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