Antifibrinolytic drug

E. Ogston, Antifibrinolytic Drugs Chemistry, Pharmacology and Clinical Usage, ]ohn Wiley Sons, Inc., Chichester, UK, 1984, p. 1. 

Petruson B. A double-bhnd study to evaluate the effect in epistaxis with oral administration of the antifibrinolytic drug tranexamic acid (Cyklokapron). Acta Otolaryngol 1974 317(Suppl) 57-61. 

Metaxas, J., and Campbell, R L. Gas Chromatographic Determination of an Antifibrinolytic Drug, e-Amino-caproic Acid... 

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

Figure 17.4 Antifibrinolytic action of the lysine analogues. Normally, plasminogen binds to fibrin at a lysine-binding site and is converted in the presence of tissue plasminogen activator (tPA) to piasmin. The lysine analogues block the lysine-bIndIng site and prevent access of plasminogen to tfie fibrin molecule. Reproduced from Dunn O, Goa KL. Drugs 1999 57 1005-32, with permission.)...

Aprotinin administration during surgery should follow heparin treatment to avoid any risk. Patients under the treatment of antifibrinolytic therapy should be treated cautiously when coadministering drugs affecting hemostasis and estrogens.229 Accumulation of albumin may occur in patients with impaired renal function if large volumes of albumin solutions are administered. 

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). 

In 2(X)7, aprotinin was temporarily withdrawn worldwide until results from the Canadian BART (Blood conservation using antifibrinolytics a randomized trial) study conducted in high-risk cardiac surgery patients was completed and evaluated. Sales of the drug were suspended in May 2008, but this suspension was lifted in Europe by the European Medicines Agency in February 2012. 

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