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Results for “Tranexamic Acid”

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At least 667 records · Page 37Linked to original sources

PubMed1983

Use of human factor VIIa in the treatment of two hemophilia A patients with high-titer inhibitors.

Two patients with hemophilia A complicated with high-titer alloantibodies have been treated by repeated infusions of microgram quantities of pure human Factor VIIa. Patient 1 was presented with a gastrocnemius muscle bleeding that involved the knee joint. Upon treatment with Factor VIIa the circumference of the muscle decreased and joint mobility increased substantially. Patient 2 was given Factor VIIa concurrent with tranexamic acid in association with the extraction of two primary molars. No significant gingival bleeding occurred after Factor VIIa and tranexamic acid treatment. Furthermore, no deleterious side effects or increase of the alloantibody level were observed in either patient throughout the Factor VIIa infusion. These results, although limited and preliminary in nature, suggest that trace quantities of Factor VIIa can act as a Factor VIII bypassing activity and restore hemostasis in these patients.

Adolescent↗

PubMed2004

[A case of anaphylactic shock with tranexamique acid (Exacyl)].

A 72-year-old male patient was scheduled for coronary artery bypass graft surgery because of severe three-vessel disease. Induction of anaesthesia was uneventful. Following bolus infusion of tranexamic acid (Exacyl), the patient presented clinical signs consistent with anaphylactic shock. Surgery was postponed and the patient recovered without sequaelae. Allergological investigations (cutaneous tests, serum IgE concentrations, in vitro histamine-release tests) suggest that this is the first reported case of anaphylactic shock to tranexamic acid. Several weeks later, the patient underwent surgery with a similar anaesthetic regimen and the clinical course was uneventful.

Aged↗

PubMed2005

Rapid administration of antifibrinolytics and strict blood pressure control for intracerebral hemorrhage.

OBJECTIVE: Hematoma growth is a major cause of poor outcome in patients with intracerebral hemorrhage. We evaluated the efficacy of a combination of rapid antifibrinolytic therapy and strict blood pressure control for prevention of hematoma growth in this retrospective study. METHODS: Systolic blood pressure was strictly controlled below 150 mm Hg by use of intravenously administered nicardipine (BPC). Prolonged infusion of antifibrinolytic therapy was given by intravenous administration of 1 g tranexamic acid over a period of 6 hours (PAF). Rapid administration of antifibrinolytic therapy was given by intravenous administration of 2 g tranexamic acid over a period of 10 minutes (RAF). Immediately after diagnosis of intracerebral hemorrhage on computed tomographic scan, 156 patients who were admitted within 24 hours of onset were treated with either a combination of PAF and BPC (PAF group) or a combination of RAF and BPC (RAF group). The incidence of hematoma growth determined by a second computed tomographic scan the day after admission was compared between the PAF and the RAF groups. RESULTS: Hematoma growth was observed in 11 (17.5%) of 63 patients in the PAF group and 4 (4.3%) of 93 patients in the RAF group using a 20% cutoff value for hematoma enlargement. The RAF group showed a significantly low incidence of hematoma growth compared with the PAF group (P < 0.05). Between the two groups, there was no significant difference in any of the other factors reported to affect hematoma growth. CONCLUSION: The combination of rapid administration of antifibrinolytics and strict blood pressure control may prevent hematoma growth in patients with intracerebral hemorrhage.

Aged↗

PubMed2005

An ionizable chromophoric reagent for the analysis of primary amine-containing drugs by capillary electrophoresis.

We found that ofloxacin acyl chloride is a potential chromophoric reagent for labeling amino analytes for capillary electrophoresis. Ofloxacin acyl chloride has a tertiary amino function in its structure and the derivatives from ofloxacin acyl chloride reacting with amino analytes can be ionized by an acid treatment and analyzed by simple capillary zone electrophoresis. Ofloxacin acyl chloride was used to derivatize model analytes (without chromophore) of amantadine (amino drug), tranexamic acid (non-protein amino carboxylic acid), glycine, and methionine (protein amino acids). The resulting derivatives were analyzed by capillary zone electrophoresis with ultraviolet detection (300 nm). The detection limits of the analytes studied were in the range of 1.0-2.5 microM (S/N = 3, injection 3 s). The precision (relative standard deviation) and accuracy (relative error) of the method for intra- and inter-day analyses of the analytes were respectively below 4.5% and 3.9%. Application of the method to the analysis of tranexamic acid in plasma proved feasible.

Amantadine↗

PubMed1979

Fibrinolysis and traumatic hyphaema.

Since January 1st 1975, 310 patients with traumatic hyphaema have been treated with the antifibrinolytic drug tranexamic acid. One secondary haemorrhage has occurred, corresponding to a frequency of secondary haemorrhage of 0.32%. Eighty-five of these patients were treated as out-patients. In four patients with traumatic hyphaema, who were not treated with tranexamic acid, the serum content of activator inhibitor was determined daily. An increase was seen during the first five days after the trauma, followed by a marked fall on the 6th day. In the same four patients, the central corneal thickness was followed by daily measurements and compared to the variation in activator inhibitor.

Adolescent↗

PubMed1989

Cytoprotective effect of plasmin inhibitor on necrotizing agent-induced gastric lesions in rats.

We studied the effect of plasmin inhibitor on ethanol and ammonia-induced gastric mucosal lesions in rats using an ex vivo chamber. Tranexamic acid and aminocaproic acid significantly inhibited macroscopic gastric hemorrhagic necrosis and attenuated the decrease of gastric transmucosal potential difference induced by 50% ethanol and 1% ammonia. The protection of gastric mucosa afforded by tranexamic acid and aminocaproic acid was not affected by pretreatment with indomethacin (5 mg/kg). These results suggest that plasmin inhibitor plays an important role in the prevention of gastric deep necrosis following exposure of the stomach to a damaging agent.

Aminocaproic Acid↗

PubMed1993

Visualization of the plasmin receptor on sections of human mammary carcinoma cells.

In previous studies we observed the presence of an antigen reacting with anti-plasminogen serum on tumor cells found in sections of human colorectal and mammary carcinomas, using immunofluorescence. This antigen could be plasminogen, or plasmin or both. These results led us to surmise that carcinoma cells, and not normal epithelial cells, had a receptor for plasmin and plasminogen. We demonstrated the existence of such a receptor on cells of established tumor cell lines of colonic and mammary origin. We observed that binding of plasmin(ogen) to its receptor was inhibited by lysin and its analogs. We undertook to characterize the plasmin receptor on sections of human mammary carcinomas (18 series of sections, originating from 15 infiltrating ductal carcinomas). In our immunofluorescence studies, we observed that the fluorescence induced by anti-plasminogen serum was suppressed by pre-treatment of the sections with tranexamic acid, a lysin analog. Furthermore, when parallel sections were incubated with tranexamic acid, then with solutions of plasminogen, tumor cells were made fluorescent again. Another important finding was the strong increase of labelling observed when sections were incubated with plasminogen or plasmin before reaction with anti-plasminogen serum. This labelling disappeared when tranexamic was added to plasminogen. As a whole, these results confirm the existence of plasmin receptors on tumor cells in mammary carcinoma sections. They also show that these receptors are not saturated in vivo and may bind, in vitro, additional amounts of ligand.

Breast Neoplasms↗

PubMed1996

Cost/benefit analysis of pharmacologic hemostasis.

BACKGROUND: Surgical bleeding with possible associated coagulopathies is a major source of morbidity and mortality. More than 27% of patients receive unnecessary blood or blood-product transfusions during cardiac operations. Analysis of the cost-benefit of pharmacologic hemostasis can be accomplished by relating all the components of cost, which include both direct and indirect costs to both direct and indirect benefits to the patient. METHODS: A significant reduction in transfusion requirements can be achieved by the systematic application of a clinical algorithm. An alternative is to use drugs that enhance hemostasis. Four such drugs commonly used are desmopressin acetate, tranexamic acid, epsilon-aminocaproic acid, and aprotinin. All these agents have been shown to successfully reduce bleeding and the need for transfusion. It appears that the order of efficacy (greatest to least) is aprotinin, tranexamic acid, epsilon-aminocaproic acid, and desmopressin acetate. RESULTS: Cost/benefit analysis associated with the use of these agents is complex. The direct costs of these drug treatments can be balanced against the costs related to blood and blood-product administration. Using epsilon-aminocaproic acid, blood used is valued at $30, whereas the drug treatment cost is less than $2. Aprotinin use results in costs of more than $500, with the drug costing $900. CONCLUSIONS: Improved hemostasis should also result in indirect cost savings from reduced operating room time, reduced intensive care unit and hospital stay, and the avoidance of reoperation for bleeding.

Aminocaproic Acid↗

PubMedDate not supplied

Effect of antifibrinolysis treatment on human cancer in nude mice.

The effect of tranexamic acid on the growth of three human tumor cell lines (lung squamous cell carcinoma QG-56, lung adenocarcinoma PC-12 and ovarian carcinoma OC-1) was investigated in vitro and in vivo in nude mice. Tranexamic acid exhibited no direct cytotoxicity in vitro, but it inhibited the growth of all the three cell lines as tumors in nude mice. Prominent deposition of fibrin or fibrinogen around tumor cells at the advancing border were observed only in the tumors of treated animals.

Animals↗

PubMed1985

[Pharmacokinetic and pharmacological studies on cetraxate, an anti-ulcer agent].

Cetraxate hydrochloride was administered either orally or intravenously to rabbits, and its concentration in body fluids was determined by using the HPLC method. Cetraxate was easily hydrolyzed in the gastrointestinal tract and blood, and it was metabolized to p-hydroxyphenylpropionic acid (PHPA) and a new metabolite, p-hydroxybenzoic acid (PHBA). After oral administration of cetraxate hydrochloride, a large amount of unchanged drug was distributed to the gastric wall. PHPA was distributed in all the organs examined, excluding the brain. To determine whether or not the anti-ulcer action of cetraxate hydrochloride was due to the unchanged drug, PHPA, or tranexamic acid, studies with aspirin and water-immersion -induced gastric ulcers in rats were performed. As a result, it was found that tranexamic acid had an anti-ulcer action similar to that of cetraxate hydrochloride.

Animals↗

PubMed1998

Platelets and soluble fibrin promote plasminogen activation causing downregulation of platelet glycoprotein Ib/IX complexes: protection by aprotinin.

Blood loss during and after open-heart surgery with cardiopulmonary bypass (CPB) is largely caused by platelet dysfunction. Previous studies indicate that plasmin can induce platelet dysfunction and affect primary hemostasis by proteolytic degradation and/or redistribution of essential platelet membrane glycoprotein complexes such as the glycoprotein Ib/IX complex. In this study, we present a model for plasmin generation localized on the platelet surface. Platelets treated with soluble fibrin or platelets in a mixture with soluble fibrin, t-PA, and plasminogen caused a significantly increased plasmin generation (p<0.01), dependent on t-PA, soluble fibrin, and platelet concentration. The plasmin generation resulted in a downregulation of platelet membrane glycoprotein Ib/IX glycoprotein complexes. Finally, we demonstrated that inhibitors of fibrinolysis, such as %2-antiplasmin, tranexamic acid, and aprotinin, can inhibit plasmin activity in the fluid phase. The downregulation of platelet glycoprotein Ib/IX complexes, however, was only prevented by aprotinin and not by alpha2-antiplasmin and tranexamic acid. These in vitro observations suggest a platelet localized activation of plasminogen, dependent on t-PA, enhanced by the presence of soluble fibrin. Since high concentrations of soluble fibrin and elevated levels of t-PA during CPB are observed, plasmin activity on the platelet surface during this period is anticipated. This plasmin activity reduces platelet metabolic functions and can be directed towards membrane glycoproteins such as glycoprotein Ib/IX complexes, thereby affecting hemostasis during and after CPB.

Antibodies, Monoclonal↗

PubMed1996

[Oral surgical procedures during anticoagulant therapy].

Minor oral surgery, in patients being treated with anticoagulant therapy, constitutes a problem for the oral and maxillofacial surgeon. 77 patients getting coumarin underwent 168 oral surgical procedures (tooth extraction, apicoectomy, crown-lengthening, excision of lesions) without lowering the dose of anticoagulant. Local hemostasis was achieved in all cases by silk suture. For tooth extraction gelfoam was used as well. In 12 patients who presented with postoperative bleeding, it was controlled in all by gauze pressure with tranexamic acid and/or biologic glue and/or surgical splinting. Postoperative bleeding was not correlated with the international normalized ratio (INR), but with degree of local inflammation. The study shows that interruption of anticoagulant therapy in such cases is not justified, and the use of tranexamic acid or biological glue can control bleeding.

Adult↗

PubMed1990

Histologic studies on endometrium of menstruating monkeys wearing IUDs: comparative evaluation of drugs.

A comparative study was performed to evaluate the effects of antifibrinolytic agents; epsilon-aminocaproic acid (EACA) and tranexamic acid (AMCA); anti-inflammatory drugs (indomethacin, ibuprofen, naproxen); and plant extract (root extract of Boerhaavia diffusa) on the endometrial histology of IUD-fitted menstruating monkeys. A high degree of stromal edema, heavy infiltration of inflammatory cells, long, tortuous endometrial glands, and thin-walled empty blood vessels were observed in IUD endometrium. B. diffusa was found most effective in reducing stromal edema, inflammation, and tortuosity of glands, and in increasing the degree of deposition of fibrin and platelets in the vessel lumen. Antifibrinolytic agents caused partial to complete occlusion of the vessel lumen and anti-inflammatory drugs thickened the vessel wall. Indomethacin reduced inflammation effectively. Conclusively, B. diffusa appears to be a potent antifibrinolytic and anti-inflammatory agent and is, thus, recommended for the treatment of IUD menorrhagia.

Animals↗

PubMed1997

Thrombotic complications in acute promyelocytic leukemia during all-trans-retinoic acid therapy.

A case of acute renal failure, due to occlusion of renal vessels in a patient with acute promyelocytic leukemia (APL) treated with all-trans-retinoic acid (ATRA) and tranexamic acid has been described recently. We report a case of acute renal failure in an APL patient treated with ATRA alone. This case further supports the concern about thromboembolic complications associated with ATRA therapy in APL patients. The patients, a 43-year-old man, presented all the signs and symptoms of APL and was included in a treatment protocol with ATRA. After 10 days of treatment, he developed acute renal failure that was completely reversible after complete remission of APL was achieved and therapy discontinued. We conclude that ATRA is a valid therapeutic choice for patients with APL, although the procoagulant tendency is not completely corrected. Thrombotic events, however, could be avoided by using low-dose heparin.

Acute Kidney Injury↗

PubMed2000

Traumatic hyphema: a comprehensive review of the past half century yields 8076 cases for which specific medical treatment reduces rebleeding 62%, from 13% to 5% (P<.0001).

PURPOSE: To eliminate the continuing so-called "controversy" regarding, and opposition to, the specific medical management of traumatic hyphema (TH) with systemic antifibrinolytic agents including aminocaproic acid (ACA) and tranexamic acid (TXA) and steroids (prednisone); to illuminate the role of topical steroids. METHOD: Review of all (English language) studies since 1950 of these medical treatments of TH, and contemporary no specific medical treatment controls. RESULTS: The difference between the average rebleeding rate in the specifically medically treated group, 4.89%, and that rate in the untreated group, 13.02%, was statistically a true difference due not to chance but to the difference in therapy with a probability of <0.0001 by Chi Square Test, Yates Corrected Chi Square Test and Fisher's Exact Test. This was also true individually respectively and with identical probabilities of p=<0.0001 for systemic steroids, topical steroids, ACA and TXA. Combined topical steroids and systemic ACA or TXA did not further improve results. CONCLUSION: Preventing rebleeding episodes remains a major treatment objective in the clinical management of TH. This is best accomplished by the Yasuna systemic steroid No Touch or No Touch PLUS treatment protocol, the only treatment protocols consistently yielding zero rebleed rates in non-Scandinavian populations.

Anterior Eye Segment↗

PubMed1991

Studies on tumor induced angiogenesis.

Methods were developed to test the angiogenic response to human tumor implants and various biologic agents in the cornea of rabbits and non-human primates (Macaca arctoides). Human malignant melanoma tissue and crude platelet derived growth factor (PDGF) preparations had significant angiogenic effects. Purified, recombinant PDGF preparations were also effective initiators. Hemorheologic agents which also inhibit platelet aggregation [e.g. pentoxifylline (Px) (Trental) (also found to release PgI2 and tissue plasminogen activator (t-PA)] inhibited human tumor implant-induced angiogenesis. Sodium diethyldithiocarbamate (DDTC), a metal complexing agent with special affinity to copper and anti-thyroid as well as immune stimulating activity, was shown to be anti-angiogenic and to increase the effect of Px. The anti-fibrinolytic agents epsilon amino caproic acid (EACA) and tranexamic acid (t-AMCHA) were anti-angiogenic.

Animals↗

PubMed2003

[Protocol for adapting treatment with vitamin K antagonists before dental extraction].

BACKGROUND: The purpose of this study was to validate a protocol for dental extraction in patients taking vitamin K antagonists without changing the treatment when the INR is lower than 2.8. MATERIAL AND METHODS: One hundred four extractions (96 patients) were performed during a 9 month period in patients taking vitamin K antagonists. Extraction was performed when the international normalized ratio (INR) was less than 2.8, otherwise, the treatment was modified until the desired INR was reached. Extractions were performed under para-apical and alveolar local anesthesia and sutured with hemostatic gauze. RESULTS: Three patients developed postoperative bleeding requiring alveolar revision with local application of tranexamic acid and in one case use of a biological glue. DISCUSSION: The following protocol can be proposed: ambulatory extraction under local anesthesia with an INR the day before extraction: the extraction is performed if the INR is<=2.8 using hemostatic gauze suture and tranexamic acid in case of persistent bleeding.

Adolescent↗

PubMed2002

Desmopressin in the treatment of menorrhagia in women with no common coagulation factor deficiency but with prolonged bleeding time.

The objective of this study was to investigate the efficacy and safety of desmopressin (1-desamino-8-D-arginine vasopressin) compared with placebo in the reduction of menstrual blood loss in women with menorrhagia and prolonged bleeding time, but without common coagulation factor deficiencies. We performed a randomized, double-blind, cross-over study using 300 microg desmopressin nasal inhalation or placebo treatment in one of the two first treatment cycles. Desmopressin was given only for the 2 days during which the bleeding had been at a maximum in the previous baseline cycle. A third open cycle involved combined treatment with desmopressin and tranexamic acid during the 2 days for all patients. Menstrual blood loss during the treatment periods was compared with blood loss during placebo-treated periods using objective measurement. A significant reduction of menstrual blood loss was found in the cycles treated with combined desmopressin and tranexamic acid compared with placebo. When analyzing the blood loss during the two treatment days, there was a significant reduction in blood loss for the 2 days with desmopressin alone versus placebo. The treatment was well tolerated and no serious adverse events were recorded. In conclusion, we find that nasal desmopressin is a possible complement for the medical treatment of menorrhagia.

Adult↗