Tranexamic Acid

[Squarestate]

I'm a nursing student, just starting my rotation on Ortho. I'm having trouble understanding why this drug, Tranexamic Acid, is used so much on the unit. From my understanding it helps the normal clotting process, preventing excess bleeding after surgery. My question is? Wouldn't it then increase your risk for DVT? Any thoughts? How would you explain to a patient what the purpose of the medication is? My co assign nurse was having problems really finding a way to put it in laymans terms.

[caringfornurses]

tranexamic acid does not help to form clots. It actually helps prevent clots from breaking down after surgery. Interestingly, we have been using it for a while and it seems to work. Part of the normal clotting process includes the breaking down of clots and then rebuilding. This may be too much information for your patient, but this is how I explain it:

This medication will reduce your risk of bleeding and reduce the need for a blood transfusion.

If they ask, I will explain that it works to keep the clot from breaking down and forming a new one, reducing that blood loss.

I do warn that it does cause nausea. Especially when being transported during the administration.

[Morainey, BSN, RN]

The half life is about 3 hours, as I recall. Most of our folks get it during surgery and, anecdotally, our use of drains seems to have decreased. Just my 2 cents :)

[november17, ASN, RN]

Interestingly, I read about nausea being a side effect, but brushed it off as the usual "nausea and vomiting" side effect of most drugs. That actually explains a lot of cases I see day in and day out. Interesting tid bit of info, thank you!

[adamRn79, BSN, RN]

I believe it is put in surgery site, not IV

[akulahawkRN, ADN, RN, EMT-P]

TXA is also starting to be used in trauma as well. It's an antifibrinolytic. It prevents clot breakdown vs encouraging clot formation. If there's not clot, it won't have anything to do, so it'll hang out for a while until it's eventually broken down. While this is a wikipedia entry, this gives you and idea of what and how TXA can be used. Tranexamic acid - Wikipedia, the free encyclopedia

It can be given IV, and that route is very commonly used in trauma. Apparently it's been somewhat successful in that area, so the trauma folks might be a bit excited to use it...

[GinaIgel]

I work in surgery. The anesthesiologist gives it IV, usually at the beginning and end of our total joint procedures.

[tjdionson]

Interesting read... Our joint docs just started using this maybe a month ago and I have noticed that we are not transfusing blood as much. Our protocol is usually the Hemovacs remain clamped two hours after surgery then unclamped and placed to self suction.