Tranexamic acid
Tranexamic acid is a synthetic lysine analogue used as an **antifibrinolytic** to control bleeding. It is particularly beneficial in patients with **hyperfibrinolytic conditions** and certain forms of **coagulopathy**. **Clinical Pearl:** Commonly used in veterinary medicine for trauma, surgical bleeding (e.g., greyhound surgeries), and bleeding associated with *Angiostrongylus vasorum* (lungworm) or immune-mediated thrombocytopenia (IMTP). > **Warning:** Use with caution in patients with renal impairment or pre-existing thromboembolic disease.
Mecanismo: Tranexamic acid is a synthetic lysine analogue that reversibly binds to the **lysine binding sites of plasminogen**. Plasminogen → (blocked by TXA) → Plasmin This prevents the action of plasmin on fibrin, thereby delaying **fibrin dissolution** (fibrinolysis) and reducing bleeding. By stabilizing the clot, it helps maintain hemostasis in bleeding disorders.
Vías de administración
Contraindicaciones
- Disseminated intravascular coagulation (DIC)
- Thromboembolic disease
- Severe renal impairment (without dose adjustment)
Efectos adversos
- Gastrointestinal upset (vomiting, diarrhea)
- Hypotension (if given rapidly IV)
- Seizures (at high doses)
- Retinal changes (rare, high doses)
Interacciones farmacológicas
- Estrogens · Increased risk of thrombosis · moderate
- Tissue plasminogen activators (e.g., alteplase) · Antagonizes fibrinolytic effects · major
Monitoreo
- Clinical signs of bleeding
- Coagulation profiles (PT, aPTT, TEG/ROTEM)
- Renal function
Sobredosis
Overdosage may result in severe **gastrointestinal signs** (vomiting, diarrhea), **hypotension**, and neurological signs including **seizures** (due to GABA-A receptor antagonism). Treatment is symptomatic and supportive.
La referencia de fármacos de VetSheet está destinada a médicos veterinarios como apoyo a la decisión clínica; no sustituye el juicio profesional ni la información vigente del fabricante.