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* Inhibits both plasminogen activation and plasmin activity, thus preventing clot break-down rather than promoting new clot formation. With massive bleeding this may help stabilize clot formation and decrease extravascular bleeding. | * Inhibits both plasminogen activation and plasmin activity, thus preventing clot break-down rather than promoting new clot formation. With massive bleeding this may help stabilize clot formation and decrease extravascular bleeding. | ||
'''INDICATIONS''' | '''INDICATIONS''' | ||
* [[Hemorrhagic Shock|Severe Hemorrhagic Shock]]. | * [[Hemorrhagic Shock|Severe Hemorrhagic Shock]] or imminent shock. | ||
*Strongly consider in non-traumatic bleeding (post-partum, gastrointestinal, postoperative, nasal) | *Strongly consider in non-traumatic major bleeding (post-partum, gastrointestinal, postoperative, nasal) with signs of shock or imminent shock. | ||
'''PREGNANCY CATEGORY''' | '''PREGNANCY CATEGORY''' | ||
| Line 14: | Line 14: | ||
* Safe in breastfeeding | * Safe in breastfeeding | ||
''' | '''CONTRAINDICATION''' | ||
* Hypersensitivity to TXA | * Hypersensitivity to TXA | ||
'''RELATIVE CONTRAINDICATIONS''' | |||
* Colorblindness | * Colorblindness | ||
* History of Seizures | * History of Seizures | ||
Latest revision as of 15:10, 8 February 2021
Section 8 - MEDICATION GUIDELINES
ANTI-FIBRINOLYTICS
Tranexamic Acid (TXA)
DESCRIPTION
- Inhibits both plasminogen activation and plasmin activity, thus preventing clot break-down rather than promoting new clot formation. With massive bleeding this may help stabilize clot formation and decrease extravascular bleeding.
INDICATIONS
- Severe Hemorrhagic Shock or imminent shock.
- Strongly consider in non-traumatic major bleeding (post-partum, gastrointestinal, postoperative, nasal) with signs of shock or imminent shock.
PREGNANCY CATEGORY
- B - Safe in Pregnancy
- Safe in breastfeeding
CONTRAINDICATION
- Hypersensitivity to TXA
RELATIVE CONTRAINDICATIONS
- Colorblindness
- History of Seizures
- Ischemic event: Myocardial Infarction, stroke, pulmonary embolism (PE), deep venous thrombosis (DVT)
- Isolated head injury / subarachnoid hemorrhage
PRECAUTIONS
- Rapid injection can cause hypotension
DOSAGE
- 1000 mg of TXA mixed in 100 ml or 250 ml of normal saline infused via IO or IV over 10 minutes.
- 20mg/kg (1000mg maximum) TXA mixed in 100 ml of Normal Saline infused via IO or IV over 10 minutes.