Транексамовая кислота

Описание

Tranexamic acid is a derivative of aminomethylbenzoic acid, and a kind of antifibrinolytic drugs to stop bleeding. The hemostasis mechanism of tranexamic acid is similar to aminocaproic acid and aminomethylbenzoic acid, but the effect is stronger. The strength is 7 to 10 times of aminocaproic acid, 2 times of aminomethylbenzoic acid, but toxicity is similar.
The chemical structure of tranexamic acid is similar to lysine, competitive inhibition of plasmin original in fibrin adsorption, to prevent their activation, protection fiber protein not to degrade by plasmin and dissolve, eventually achieve hemostasis. Applicable in the treatment of acute or chronic, localized or systemic primary fiber fibrinolytic hyperthyroidism caused by bleeding, such as obstetric hemorrhage, renal hemorrhage, hemorrhage of hypertrophy of the prostate, hemophilia, pulmonary tuberculosis hemoptysis, stomach bleeding, after operation of liver, lung, spleen and other viscera hemorrhage; also can be used in surgery when abnormal bleeding etc..
Clinical tranexamic acid has effect significantly to insect bites disease, dermatitis and eczema, simple purpura, chronic urticaria, artificial sex urticaria, toxic eruption and eruption. And also has a certain effect on erythroderma, scleroderma, systemic lupus erythematosus (SLE), Erythema multiforme, shingles and alopecia areata. Treatment of hereditary angioedema effect is also good. In the treatment of Chloasma, general medicine is effective about 3 weeks, markedly effective 5 weeks, a course of 60 days. Given orally in doses of 0.25 ~ 0.5 g, a day 3 ~ 4 times. A few patients can nausea, fatigue, pruritus, abdominal discomfort, and diarrhea side effects after withdrawal symptoms disappear.

Химические свойства

Tranexamic acid is a White or almost white, crystalline powder. It is freely soluble in water and in glacial acetic acid and is very slightly soluble in ethanol and practically insoluble in ether.

Использование

Fibrinolysis, the cleavage of fibrin by plasmin, is a normal step in the dissolution of fibrin clots after wound repair. Tranexamic acid is an inhibitor of fibrinolysis that blocks the interaction of plasmin with fibrin (IC50 = 3.1 μM). It is a lysine mimetic that binds the lysine binding site in plasmin. Antifibrinolytic agents have value when fibrinolytic activity is abnormally high or when coagulation is impaired.

Определение

ChEBI: Tranexamic acid is a monocarboxylic acid. It has a role as an antifibrinolytic drug and a hematologic agent. It is functionally related to a cyclohexanecarboxylic acid.

Общее описание

Tranexamic acid is an antifibrinolytic agent and is commonly used for heavy menstrual bleeding.

Механизм действия

Tranexamic acid is a synthetic lysine amino acid derivative, which diminishes the dissolution of hemostatic fibrin by plasmin. In the presence of tranexamic acid, the lysine receptor binding sites of plasmin for fibrin are occupied, preventing binding to fibrin monomers, thus preserving and stabilizing fibrin’s matrix structure. This agent has a longer half-life, is approximately ten times more potent, and is less toxic than aminocaproic acid, which possesses similar mechanisms of action.

Побочные эффекты

Tranexamic acid is mostly well-tolerated.
Common
nausea (upset stomach)
vomiting (throwing up)
diarrhea
headache

Occasional
dizziness
giddiness
vision changes

Rare
stroke
blood clots in undesired areas
deep vein thrombosis

использованная литература

Intravenous use of tranexamic acid reduces postoperative blood loss in total knee arthroplasty DOI:10.1007/s00402-014-2081-x
www.childrensmn.org
dermnetnz.org
Tranexamic acid for the prevention and treatment of postpartum haemorrhage. DOI:10.1097/01.aoa.0000552886.12061.3c
Sittig's Pharmaceutical Manufacturing Encyclopedia
The Renal Drug Handbook
Synthesis of Essential Drugs (2006, Elsevier) - libgen.lc
Spectrophotometric and spectrofluorimetric methods for the determination of tranexamic acid in pharmaceutical formulation. DOI:10.1248/CPB.55.364
Determination of plasma tranexamic acid using cation-exchange high-performance liquid chromatography with fluorescence detection. DOI:10.1016/S0378-4347(00)84573-9
[1] A Pilbrant, J Vessman, M Schannong. “Pharmacokinetics and bioavailability of tranexamic acid.” European Journal of Clinical Pharmacology 20 1 (1981): 65–72.