Tranexamic acid is used to prevent and treat bleeding from dental surgery in hemophiliacs (people with deficiency of coagulation factors VIII or IX).
Mechanism of action
Tranexamic acid in the prevention and treatment of bleeding due to dental surgery in hemophiliac patients.
Tranexamic acid competitively inhibits plasminogen activation, thereby reducing the conversion of plasminogen to plasmin (fibrinolysin). It also directly inhibits plasmin activity, but large amounts are needed to produce this effect.
30-50% of the intake is absorbed from the gastrointestinal tract. Less than 5% of the drug is metabolized. The half-life of the drug is approximately 2 hours. The time required to reach the peak plasma concentration orally is approximately 3 hours. The maximum oral plasma concentration after a single gram dose is 8 mcg / ml. The drug is excreted by glomerular filtration. Up to 39% of the drug is excreted in the urine within 10 hours after oral administration of 10-15 mg / kg and 90% of the dose of 10 mg / kg is excreted in the urine within 24 hours.
The use of this drug in pregnant women is strictly prohibited and is classified as group X. May cause death or organ failure. This drug should not be used in patients with intravascular clot formation.
It should be used with caution in the following cases: Patients with color vision impairment, severe hematuria (should not be used in case of obstruction of the aorta) Subarachnoid hemorrhage, renal impairment, history or susceptibility to thrombosis. In the long-term treatment of patients with hereditary angioedema, regular eye examinations and liver function tests are important in monitoring the patient’s condition. Injectable tranexamic acid should be given at a maximum rate of 100 mg / min to prevent hypotension.
Nausea, vomiting, diarrhea, and rapid intravenous injection have been reported.
To prevent bleeding in hemophiliac patients, 25 mg / kg is used every 6-8 hours one day before surgery. After surgery, 25 mg / kg is used every 6-8 hours for 7-10 days.
10 mg / kg is injected intravenously immediately before surgery (injectable form is preferable to oral administration). After surgery, in patients who are unable to take the drug orally, 10 mg / kg is given intravenously every 6-8 hours for 7-10 days.
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