Intravenous Therapy with Tranexamic Acid in Severe Trauma

Mechanism of action: blocks conversion of plasminogen to plasmin by blocking lysine binding sites, thereby reducing fibrinolysis

Patient selection - both of the following:

(1) Adult trauma patient at risk for severe bleeding.

(2) The drug can be administered within 3 hours of injury (decreased mortality and decreased bleeding).

Dosing:

(1) loading dose: intravenous infusion of 1 gram in 1 gram in 100 mL normal saline over 10 minutes

(2) slow infusion of 1 gram over 8 hours

If the drug is started from 3 to 8 hours after the trauma then mortality is reduced but the risk of bleeding is increased.