Brand name: Cyklokapron/Lysteda

Generic name: Tranexamic Acid

Classification:
 Therapeutic: hemostatic agents
 Pharmacologic: fibrinolysis inhibitors

Mechanism of action: Tranexamic acid competitively inhibits activation of plasminogen

thereby reducing conversion of plasminogen to plasmin (fibrinolysin), an enzyme that
degrades fibrin clots, fibrinogen, and other plasma proteins, including the procoagulant
factors V and VIII.
In patients with hereditary angioedema, inhibition of the formation and activity of
plasmin by tranexamic acid may prevent attacks of angioedema by decreasing plasmin-
induced activation of the first complement protein (C1).

Adverse effect:
 Hypersensitivity reactions
 Cerebrovascular infarction
 Myocardial infarction
 Pulmonary embolism

Side effect:
 Nausea
 Vomiting
 Diarrhea
 Hypotension
 Thromboembolic, e.g., arterial, venous, embolic;
 Neurologic, e.g., visual impairment, convulsions, headache, mental status
changes; myoclonus;
 Rash

Nursing responsibilities:
Before:
 Monitor blood pressure, pulse, and respiratory status as indicated by severity of
bleeding.
Rationale: This is to ensure that the patient is in a steady state where the blood
pressure is within normal levels, the pulse rate are not decreasing over time
and the respiratory system are supplying enough oxygen.
 Monitor for overt bleeding every 15–30 min.
Rationale: To determine excessive bleeding and effectivity of drug.
  Monitor neurologic status (pupils, level of consciousness, motor activity) in
patients with subarachnoid hemorrhage.
Rationale: Subarachnoid hemorrhage is a life threatening form of stroke and
therefore requires intensive care and observation.
 Assess for thromboembolic complications.(especially in patients with history).
Notify physician of positive Homans’ sign, leg pain hemorrhage, edema,
hemoptysis, dyspnea, or chest pain.
Rationale: A thromboembolic complication can break loose and cause a
serious problem in the lung, called a pulmonary embolism, or a heart attack or
stroke if not treated immediately.
 Monitor platelet count and clotting factors prior to and periodically throughout
therapy in patients with systemic fibrinolysis.
Rationale: To ensure that the Coagulation cascade within the patients body,
there are no excessive clotting or bleeding that happens throughout the body.
During:
 Stabilize IV catheter. Monitor site closely.
Rationale: To minimize thrombophlebitis.
After:
 Instruct patient to notify the nurse immediately if bleeding recurs or if
thromboembolic symptoms develop.
Rationale: In order for the nurse to possibly make immediate action to resolve
the bleeding.
 Caution patient to make position changes slowly.
Rationale: To avoid orthostatic hypotension.