Difference between revisions of "Tranexamic acid"

(Background)
(Administration)
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==Administration==
 
==Administration==
*Adult dose- Total of 2 Gms
+
===Adult dose===
**Initial bolus of 1 Gm over 10 minutes (Slow IV push). Draw up with filter needle.
+
''Total of 2 Grams''
**Maintenance: additional 1 Gm over next 8 hours (mix in 50 mL of NS). Call Pharmacy to mix and deliver the continuous infusion.
+
*Initial bolus of 1 Gm over 10 minutes (Slow IV push). Draw up with filter needle.
*Pediatric dose- (weight based)
+
*Maintenance: additional 1 Gm over next 8 hours (mix in 50 mL of NS). Call Pharmacy to mix and deliver the continuous infusion.<ref>CRASH-2 collaborators, Roberts I, Shakur H, Afolabi A, Brohi K, Coats T, Dewan Y, Gando S, Guyatt G, Hunt BJ, Morales C, Perel P, Prieto-Merino D, Woolley T. The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. Lancet. 2011 Mar 26;377(9771):1096-101,</ref>
**Initial bolus of 20 mg/kg IV Bolus over 10 minutes
+
===Pediatric dose===
**Maintenance: 10 mL/kg/hr over next 8 hours
+
''Weight based''
 +
*Initial bolus of 20 mg/kg IV Bolus over 10 minutes
 +
*Maintenance: 10 mL/kg/hr over next 8 hours
  
No additional laboratory tests required.  
+
No additional laboratory tests required.
  
 
==Adverse Reactions==
 
==Adverse Reactions==

Revision as of 14:29, 10 December 2014

Background

  • Action: Antifibrinolytic agent
  • Dosing Availability:
    • Ampule of 1 Gm in 10 mL

Indication

Severely bleeding trauma patient, systolic blood pressure of <90 and/or heart rate > 110 beats/min., with expected requirement for massive transfusion.

Contraindication/Exclusion Criteria

  • Greater than 3 hours from injury
  • Known sensitivity to TXA
  • Previous DVT or Pulmonary Embolism

Administration

Adult dose

Total of 2 Grams

  • Initial bolus of 1 Gm over 10 minutes (Slow IV push). Draw up with filter needle.
  • Maintenance: additional 1 Gm over next 8 hours (mix in 50 mL of NS). Call Pharmacy to mix and deliver the continuous infusion.[1]

Pediatric dose

Weight based

  • Initial bolus of 20 mg/kg IV Bolus over 10 minutes
  • Maintenance: 10 mL/kg/hr over next 8 hours

No additional laboratory tests required.

Adverse Reactions

  • Thrombotic events
  • Hypotension with rapid injection
  • Nausea, vomiting, diarrhea
  • Impaired color vision and other visual disturbances

See Also

External Links

Source

Harbor-UCLA Tranexamic Acid (TXA) Guidelines for Administration in Trauma

  1. CRASH-2 collaborators, Roberts I, Shakur H, Afolabi A, Brohi K, Coats T, Dewan Y, Gando S, Guyatt G, Hunt BJ, Morales C, Perel P, Prieto-Merino D, Woolley T. The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. Lancet. 2011 Mar 26;377(9771):1096-101,