Tranexamic Acid (TXA) - Critical Care Medications
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- čas přidán 24. 07. 2024
- Let's take a look at our next critical care medication, Tranexamic Acid (TXA). I mentioned this medication in the last lesson talking about massive transfusion protocol, but it has additional uses beyond that in which you guys might use it. It's an interesting medication in how it works, so let's talk about all that, some of it's effects, dosing, and why we use it!
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0:00 Intro
0:59 What is TXA?
3:03 How it works
4:56 Side effects
5:58 Dosing
6:42 Uses in CC
9:42 Wrap up
#ICUAdvantage #TXA #Medications
I recently gave an inhaled dose of TXA via a nebulizer to a patient experiencing DAH (diffuse alveolar hemorrhage) and it seemed to work quite well.
Was your patient tubed or had a trach tube. Did you know if airway is contraindication for this med?
I legit just used IV TXA yesterday for adjunctive therapy (along side ffp) for a patient with angioedema 2/2 ace inhibitor use ...so crazy how these meds have off label uses haha (you also always put out videos legit the day after I encounter a situation, and it really helps me debrief on why I did what I did/used what medications I used...so thank you!!!!)
Following, everyday I have to watch at least a video from this channel, as a registered nurse working in the ICU I found this channel very helpful...
Few days since I found your channel. Videos are really helpful.
Such a great video! Very informative and a good review!
Really happy to hear you found it helpful
Thank you so much. Your channel has helped me a lot
Awesome! So glad to hear this!
Thanks for all lecture,
I follow all ,and really excellent and useful practically
Dr Amaranath, India
I am an AG-ACNP (a nurse practitioner) and I am doing a fellowship in critical care this fall. I found this video concise and informative, and will serve as good knowledge in my fellowship. Thanks!
Heavy bleeding due to fibroids and tranexamic acid helped me .
Thank you ! I'm trying it now.
We use it in ophtalmic surgery. IV prior the operation, when high risk of intraocular bleeding is estimated, either in front chamber of in posterior segment. I use 500 mg 10, min infusion, and if needed 500 mg again.
We are using as eye drops for hyphema.
Also for oculoplastic surgery if needed.
When i used to work in burn unit, I ussed TXA a lot. The usual dose reduced the need of blood products nearly 50%. That was magic.
Can you make a video that speaks on the different scans patients undergo and indications? Examples being CT, MRI, HIDA, VQ, Brain perfusion, etc …
I got txa in the ED via new for post surgical bleed post tonsillectomy. The PA-C didn’t know much about it..... I had to teach him prior to admin
Love ur explanation ❤️❤️ keep it up
Thank you!
Sir good presentation very useful...can you do vedeo on manitol in head injury
It's interesting how different the Army combat medic course is from civilian medicine.
I was taught 1g TXA/10mL over 30 seconds for two consecutive doses through syringes into a saline lock, so 2 grams within about a minute. Way different timing than what you're suggesting. I'm sure the administration would be much slower in a less austere environment, though (I've just started the fieldcraft portion of the course so they might teach different ways to administer TXA based on situation)
Great video. Thx
What about use TXA in ortho joint surgeries (Hip and Knee). What are the doses for preop, intra-op, and post-op? What are contraindications of its use? (Watchman, cardiac stents, etcs)
Good video, thanks
Thank you
Very nicely done. They also use it in Orthopedic surgery. Funny about the GI bleed data, but perhaps, the patients did not have massive enough hemorrhage? Most do stop with conservative therapy.
Thank you! Yes, I did see that about Ortho surgeries, as well as many other non CC uses. I was also surprised by the GIB data. I personally hadn't seen it used for that, but I also was curious as to what specifically about that population would be any different. I was hard pressed to think of something. Perhaps a future study will readdress this.
all i knew was txa slowed down breakdown of blood clot in bleeding, very helpful video ty
Glad you liked it!
@@ICUAdvantage :))
This was usual cus I’m taking it thanks 🙏
Glad to hear it!
Gave nebulization dose of TXA +3 cc PNSS it helped more on hemoptysis rather than IV dose
Very cool! Never seen this!
In PACU, We use PO TXA for our total joint patients. They receive a single dose of 1950 mg pre-op followed by a second dose of 1300 mg given in recovery 4-6 hrs after the initial dose. No further doses are given.
Interesting! What's the reason for giving it? Always cool to learn different ways things are used.
Pts are routinely given 1 Gram IV TXA right before surgery and additional during surgery if needed for total joint patients to decrease blood loss during surgery. These pts are also given DVT precautions post surgery to decrease risk of DVTs, so that’s good!
At our facility, the target temperature is 33 Celsius. It was an interesting point that the outcome is no different from when the target temperature is 36 Celsius. There is obvious lack of best practice in accordance with the most current research at our facility. I have even addressed that we should not be doing TTM. We want to do the best for our patients.
I think somehow you commented on the wrong video!
I do still hear of places doing 32-34 deg for TTM. It does seem as though that may not be the best approach with a slew of recent studies.
Much love Eddie
Thank you Marwan!
Very interesting been taking txa for years now to stop nosebleeds without knowing how it works
Pretty cool drug!
I recently had a provider request TXA in the setting of angioedema secondary to ACE inhibitor use (lisinopril) as an adjunct in addition to the rest of the Pepcid, Benadryl, etc cocktail. He was adamant he read studies on it’s benefit in this situation for angioedema specifically with ACE inhibitors. Can you verify this? I found one, 30 something patient trial, but it seemed hit or miss. All that stated - it worked great.
I honestly had never heard it used for this purpose, but another person also just mentioned this. I did some quick digging and it does seem to have some very limited support specifically for ACE-I related Angioedema, but apparently has been used some time for hereditary Angioedema. I'll have to do some more digging when I have more time. I'm always fascinated by the varied uses of medications and I'm curious as to how this works. Thanks for sharing!
My gyno recently prescribed this for me does it have any side effect?
we don't give TXA in GI bleeding, But I don't know cause of what is mechanical
Tranexamic infusion can be safe to be given for out patient setting for heavy menstruation?
What are your thoughts on aesthtic side effect of skin light ening?
can i take tranexamic acid while i have depo-provera injection?
What about apply TXA on face, as a skincare for hyperpigmentation..
EXCELLENT THAKMK YOU FROM SRILANKA
You're so welcome and hello in Srilanka!
Please make a video for streptokinase too..
Recently, I had a pt who was bleeding internally (approx 2L) around their surgical site, the APP ordered a TXA infusion, amongst other things and return to surgery… was this an appropriate usage?
I don't think I could comment on the appropriateness, but it sounds like they had a bleeding issue. Now whether there is any benefit (ie mortality or decreased hospital days) by using TXA, in this situation, I'm not sure if there are any studies proving or disproving. Depending what is going on with them, it certainly could have had an impact on maintaining any clots and working to help stop the bleeding, especially if they were in the hyper-fibrinolysis state.
Can we give txa IM?
What is the rationale behind TC3's guidance on TXA administration with a 2g push versus the stated initial and follow-up dose of 1g? We're currently teaching the 1g initial and follow-up for 68Ws, but wanted more clarification on the Deployed Medicine TC3 guidance on the 2g push.
I had the same question for the same reason. Did you ever get the answer?
@@joseocasio4311 I never did get an answer from Eddie, but own personal research revealed that it's a logistical issue. Both dose regimens are effective, but it's a bigger logistical issue to carry an additional two 100mL bags for TXA infusions for line medics.
Hey Eddie! Today marks my first full week orienting as a new grad Cardiac ICU nurse resident! I’ve been watching your videos to gain some knowledge of all things ICU. I have a lot to learn and hope to see more of your videos!
Do you have a video on Amiodarone? If so, could you please link it? And if not, could you please make one?
Also, I’m considering a tshirt from your channel. Do they run true to size?
Hey Morgan! First off congrats on the new position in the cardiac ICU! How exciting and so much learning in your future. It's a heck of a ride, but I'm sure you'll love it.
As for Amio, I don't have one yet, but it is on the todo list.
As for the shirts, first off, thank you for your support in considering purchasing one. I have not heard from anyone saying the sizing is off. I've only ever ordered the male ones for myself and those were as expected for the size. But if you do order, please let me know as I'd love to actually know :) Feel free to shoot me an email, which you can find in the "about" tab on the CZcams home page.
@@ICUAdvantage hi again! I haven’t yet ordered a tee but will let you know how it fits as soon as I get it!
It’s been a steep learning curve for me in the ICU so far! Im not sure how much cardiac experience you have, but I was hoping to see if you’d consider making a playlist of videos on cardiac devices? Such as balloon pumps, impellas, LVADs.
We have classes on these devices in our residency program, but I would love to hear your explanation and replay it on your channel!
@@hauthought Yes, please do let me know! I want to start getting a collection of pictures of people wearing them, so if you want to, feel free to tag me on one IG.
And yeah, the ICU, especially cardiac ICU can be a lot to take in. It def helps to be able to re-review things as time goes on.
I am planning to cover those. In fact, I'll be doing IABP here soon. Not sure yet when for Impella, VAD, and TAH. I also do have a couple already done on ECMO if you want to learn about that.
Just keep on keeping on. Its a long process and it can feel overwhelming at times, but one foot in front of the other and you'll look back and be shocked at all you've learned. Learn who you resources are and rely on their expertise and ask questions!
Thanks Eddie.........could you please make lecture on ethamsylate.please
Love from India
Not sure I’m familiar with that 🤔
Guys what to do with side effects of tranxamic acid???
Thank you for the video 🙏🙏
Also please make a video on bipap , it's settings , usage.🙏🙏
Glad you liked it!
Also: CPAP vs BiPAP lesson (czcams.com/video/Te0WLR71HwA/video.html) I think might be what you are looking for :)
Hey its useful
Eddie, is tranexamic acid used for cancer patients whose tumors increase their risk of bleeding?
I don't recall seeing this listed as a use, but it seems there are a lot of off-label uses for it, especially outside of the ICU. Including some uses in dermatology. Have you seen it used this way?
@@ICUAdvantage I’ve seen it used during procedures in cancer patients who are at an increased risk of bleeds: endoprosthetic reconstructions, arthroplasties, EGDs, and colonoscopies. I have always wondered if it is used for tumor extirpation surgeries or other procedures like that.
🔥✌️
One more use in Angioedema
Thank you! I hadn't heard of that one, but another person also just mentioned about it too.
I want to be an ICU nurse. And if I’ll be successful in this field, I will studying anesthesiologist Rn, and become anesthesiologist RN doctor by 10 years from now. Let’s see if I can do it.
Best of luck to you!
What about this medicine for menstrual cycles?
Great question. I know this area. Yes! They prescribe it for iron deficiency anemia induced to heavy periods and fibroids
I am taking this because of heavy periods. Any update on this? :/
What is MTP?
Massive transfusion protocol: czcams.com/video/IoJSN9u7qS0/video.html
Intro music was a bit loud.
Sorry about that
This ingredient is also used in skincare lol
Yes! I've seen that. It's interesting the applications of things outside of critical care that I see sometimes!
I've used it topically and it's extremely effective for hyperpigmentation and telangiectasia. It has also been suggested for reduction of neuroinflammation and reversed memory and learning deficits in aged mice (orally administered).
Camplen trendexa
Thank you!
You're welcome!