Transexamic Acid

Question 1

Drug class

Answer 1

Antifibrinolytic

Question 2

Pharmacology

Answer 2

TxA is a competitive inhibitor of plasminogen activation through the formation of a reversible complex displacing plasminogen from fibrin. This inhibits the process of fibrinolysis in addition to the protein breakdown caused by plasmin

Question 3

Metabolism

Answer 3

Hepatic with renal excretion

Question 4

Indications

Answer 4

• Recent traumatic injures (≤3hrs) with a COAST score ≥ 3 & NOT within the PATCH study catchment
• Mx of uncontrolled primary postpartum haemorrhage (≤3hrs)

Question 5

Contraindications

Answer 5

Allergy and/or known adverse drug reaction

Question 6

Precautions

Answer 6

Nil

Question 7

Side effects

Answer 7

• Headache
• Hypotension
• Nausea and/or vomiting
• Seizures

Question 8

Presentation

Answer 8

1g/10ml amp

Question 9

Route

Onset

Duration

Answer 9

IV

Mins

Serum 7-8hrs

Question 10

Adult dosages

Answer 10

• Recent traumatic injures with COAST ≥3
• Mx uncontrolled primary postpartum haemorrhage (≤3hrs)

▪︎IV 1g slow push over 10mins, single dose only
▪︎IV INF slow push over 10mins
*mix 1g in 100ml bag sodium chloride 0.9%, at approx 3drops/sec

Question 11

Paediatric dosages

Answer 11

Recent traumatic injures with COAST ≥3

*CONSULT
• IV 15mg/kg, slow push over 2-3min
Single dose only, Total max dose 1g