• Class:  Antifibrinolytic Agents

• Action: inhibits multiple plasminogen binding sites, decreases plasmin formation and fibrinolysis.

• Indications: Adult trauma with suspected hemorrhage. intra-thoracic, intra abdominal, pelvic or long bone fractures, SBP < 90mmHg OR heart rate > 100 or both. time of injury < 3 hours.

• Adverse Effects: allergy to TXA, thromboembolism, cerebral edema, cerebral infarction, seizures.  

• Contraindications: known allergy to TXA, head trauma, known (PE, DVT, or MI) DO NOT administer via IM

• Special Considerations: Pregnancy Class C 

Dosages:

Adults: 

Major trauma or potential internal bleeding 

Initial Transfusion:

• 1000mg (1gram) slow IV/IO push over 1 minute

Nosebleed

Soak a piece of gauze with TXA 500 mg and insert into        bleeding nostril with pressure applied to the nose

Persistent bleeding despite use of tourniquet

Soak gauze dressing with TXA 500 mg and insert into wound with pressure dressing

Post-operative tonsillectomy hemorrhage

TXA 500 mg via nebulized solution 

Pediatrics:

• Contraindicated