Antifibrinolytics
Antifibrinolytics include aprotinin, aminocaproic acid, and tranexamic acid. All prevent the breakdown of fibrin (!) by various mechanisms. TXA competitively inhibits plasminogen activator, reducing rate of fibrinolysis.
| Property | Tranexamic Acid (TXA) |
|---|---|
| Class | Antifibrinolytic |
| Uses | Trauma (within 3 hours), cardiac surgery, obstetric surgery, and menorrhagia |
| Presentation | Tablets, syrup, clear colourless solution for injection |
| Route of Administration | IV, PO |
| Dosing | 1g slow IV, which may be followed by infusion of 1g over 8 hours |
| Absorption | 50% bioavailability |
| Distribution | Low plasma protein binding, VD 9-12 litres |
| Metabolism | Minimal hepatic metabolism |
| Elimination | Renal of active drug - dose reduce in renal impairment |
| GIT | Nausea, vomiting |
| Haematological | Reduces fibrinolysis, possible increase in DVT/PE |
| Immunological | Allergic dermatitis |
References
- Peck TE, Hill SA. Pharmacology for Anaesthesia and Intensive Care. 4th Ed. Cambridge University Press. 2014.
- LITFL - Tranexamic Acid