Antifibrinolytic agents

H2N(CH2)jCOOH, C H,3N02. Prepared from -benzoylaminocapronitrile or from l-hydroxycyclohexylhydroperoxide, m.p. 205 0. Aminocaproic acid is an antifibrinolytic agent, used to treat thrombosis in the deep veins. amiDoethyl alcohol. See ethanolamines. 

Prophylactic treatment of Cl INH deficiency consists of Cl INH replacement infusions, androgens (danazol, stanozolol, oxymethalone) or antifibrinolytic agents. Acute treatment employs Cl INH replacement (where available), fresh-frozen plasma, and placement of an airway when significant airway obstruction is evident. Abdominal attacks require IV fluid, analgesics, and watchful waiting . 

Oral anti-coagulants Thrombolytic (fibrinolytic) drugs Antifibrinolytic agents Antiplatelet drugs CLOTTING CASCADE... 

Tranexamic acid Solubility enhancer Antifibrinolytic agent, hemophilia... 

Most of the reported thromboembolic complications occurred in elderly patients and desmopressin should not be used in patients with documented arterial disease or even in elderly patients, in whom some degree of latent arterial disease may be assumed to be present (34). Concomitant use of antifibrinolytic agents, such as tra-nexamic acid, should also be avoided. 

Serna DL, Thourani VH, Puskas JD. Antifibrinolytic agents in cardiac surgery current controversies. 

Some adverse effects are associated with all antifibrinolytic agents, reflecting their effect on clot stability. Dissolution of extravascular blood clots may be resistant to physiological fibrinolysis. These drugs should not to be used to treat hematuria due to blood loss from the upper urinary tract, as this can provoke painful clot retention and even renal insufficiency associated with bilateral ureteric obstruction (25-31). 

Caution should also be taken in the administration of antifibrinolytic agents in disseminated intravascular... 

Nilsson L, Rybo G. Treatment of menorrhagia with an antifibrinolytic agent, tranexamic acid (AMCA) a doubleblind invetsigation. Acta Obstet Gynecol Scand 1967 46 572-80. 

Other complications associated with factor administration include allergic reactions, fever, chills, urticaria, and nausea. PCCs and aPCCs also have the potential to cause thromboembolic complications, including deep vein thrombosis, pulmonary embolism, myocardial infarction, and DIG, likely related to the presence of activated factors. Antifibrinolytic agents should be avoided in patients receiving PCCs or aPCCs to avoid thrombotic complications. 

S. Sherry, A. P. Fletcher, N. Alkjaersig and W.D. Sawyer, Epsilon-amino-caproic Acid A Potent Antifibrinolytic Agent, Trans. Ass. Am. Physns 72, 62—70 (1959). 

The compositions of fibrin sealants differ all consist of fibrinogen in combination with thrombin and in some cases they include factor XIII and/or an antifibrinolytic agent, which stabilizes the clot. Their adverse effects have been highlighted [ll ]. Bovine thrombin is potentially immunogenic and can cause immunological sequelae, anaphylaxis, and... 

Death In a double-blind, randomized, placebo-controlled trial, 298 patients scheduled for low- or intermediate-risk firsttime cardiac surgery with cardiopulmonary bypass were randomized to tranexamic acid, high-dose aprotinin, or placebo. Neither antifibrinolytic agent increased the incidence of death [209 ]. However, a meta-analysis, updated in the light of these data, still showed increased mortality attributable to aprotinin (OR = 1.50 95% Cl = 1.04, 2.27) piO ]. 

Aspirin, dipyridamole, antifibrinolytic agents, aminocaproic acid, corticosteroid, interferon, embolization, cyclophosphamide, pentoxifylline, radiotherapy, and antiplatelet aggregating agents have been tried with variable success [12-14]. Heparin has been shown to boost the growth of KHE [12] and worsens the clinical situation [15,16]. 

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