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Tranexamic Acid for Trauma-Related Hemorrhage

Bailey, Abby M. PharmD, BCPS; Baker, Stephanie N. PharmD, BCPS; Weant, Kyle A. PharmD, BCPS

Section Editor(s): Weant, Kyle A. PharmD, BCPS; Column Editor

Advanced Emergency Nursing Journal: April/June 2014 - Volume 36 - Issue 2 - p 123–131
doi: 10.1097/TME.0000000000000018
Applied Pharmacology

Trauma-related deaths represent a leading cause of mortality among persons younger than 45 years. A significant percentage of these are secondary to hemorrhage. In trauma, massive and rapid loss of blood creates an imbalance in hemostasis. Mainstays of resuscitation include surgical interventions, restoring intravascular volume, and pharmacologic interventions. Providers continue to search for improved pharmacologic options for achieving hemostasis. Tranexamic acid is an antifibrinolytic and inhibits fibrinolysis by blocking the lysine-binding sites on plasminogen. Tranexamic acid works to stabilize and inhibit the degradation of existing clots. Tranexamic acid has been prospectively proven to reduce mortality in trauma-related hemorrhage. Its use will likely expand into such areas as resuscitation and massive transfusion protocols and the prehospital setting. Therefore, it is critical for emergency medicine providers to be familiar with appropriate use of tranexamic acid in order to maximize efficacy and decrease the potential adverse events.

UK Health Care, Departments of Pharmacy Services and Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky (Drs Bailey and Baker); and North Carolina Public Health Preparedness and Response, North Carolina Department of Health and Human Services, Raleigh, North Carolina (Dr Weant).

Corresponding Author: Abby M. Bailey, PharmD, BCPS, Department of Pharmacy Services, University of Kentucky HealthCare, 800 Rose St, H112, Lexington, KY 40536 (

Disclosure: The authors report no conflicts of interest.

© 2014 by Lippincott Williams & Wilkins.