TXA

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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

CONTRAINDICATIONS

  • Hypersensitivity to TXA

RELATIVE CONTRAINDICATION

  • 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.