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Tranexamic acid for epistaxis

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https://www.readbyqxmd.com/read/27769971/role-of-topical-tranexamic-acid-in-the-management-of-idiopathic-anterior-epistaxis-in-adult-patients-in-the-emergency-department
#1
Jill K Logan, Hardin Pantle
PURPOSE: The role of topical tranexamic acid in the management of anterior epistaxis in adult patients in the emergency department (ED) is examined. SUMMARY: The use of alternative agents for the treatment of epistaxis before the use of nasal packing may be reasonable due to patient discomfort, potential complications, and the need for follow-up with a healthcare provider for packing removal. One such agent is tranexamic acid. Two published studies evaluated the off-label use of topical tranexamic acid for the treatment of epistaxis...
November 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27599329/effect-of-topical-intranasal-therapy-on-epistaxis-frequency-in-patients-with-hereditary-hemorrhagic-telangiectasia-a-randomized-clinical-trial
#2
RANDOMIZED CONTROLLED TRIAL
Kevin J Whitehead, Nathan B Sautter, Justin P McWilliams, Murali M Chakinala, Christian A Merlo, Maribeth H Johnson, Melissa James, Eric M Everett, Marianne S Clancy, Marie E Faughnan, S Paul Oh, Scott E Olitsky, Reed E Pyeritz, James R Gossage
IMPORTANCE: Epistaxis is a major factor negatively affecting quality of life in patients with hereditary hemorrhagic telangiectasia (HHT; also known as Osler-Weber-Rendu disease). Optimal treatment for HHT-related epistaxis is uncertain. OBJECTIVE: To determine whether topical therapy with any of 3 drugs with differing mechanisms of action is effective in reducing HHT-related epistaxis. DESIGN, SETTING, AND PARTICIPANTS: The North American Study of Epistaxis in HHT was a double-blind, placebo-controlled randomized clinical trial performed at 6 HHT centers of excellence...
September 6, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27591836/a-systematic-review-of-anti-thrombotic-therapy-in-epistaxis
#3
K M Musgrave, J Powell
There is limited guidance available to clinicians regarding the management of antithrombotic therapy during epistaxis, whilst there has been an increase in the use of anticoagulation and antiplatelet therapy. In addition, the introduction of direct oral anticoagulants (DOACs), such as dabigatran and rivaroxaban, over the last decade has significantly increased the complexity of managing the anticoagulated epistaxis patient. We undertook a systemic literature review investigating potential management strategies for each class of anti-thrombotic therapy during epistaxis...
September 4, 2016: Rhinology
https://www.readbyqxmd.com/read/27253087/prophylaxis-in-von-willebrand-disease-coming-of-age
#4
Giorgia Saccullo, Mike Makris
Although in most cases von Willebrand disease (VWD) is a mild disorder, a subgroup of patients experience frequent bleeding. In contrast to severe hemophilia in which prophylaxis is the accepted standard of care, this is less frequently used in VWD. Most type 1 VWD patients can be adequately managed with episodic desmopressin and tranexamic acid. In patients with more severe disease, especially those with type 3 VWD, joint bleeds, epistaxis, menorrhagia, and gastrointestinal bleeding are problematic and usually require treatment with von Willebrand factor/factor VIII (VWF/FVIII) concentrate...
July 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27225226/definite-hereditary-hemorrhagic-telangiectasia-in-a-60-year-old-black-kenyan-woman-a-case-report
#5
Joan Chepkorir Kiyeng, Abraham Siika, Cornelius Koech, Gerald S Bloomfield
BACKGROUND: Hereditary hemorrhagic telangiectasia is a rare autosomal dominant inherited disease characterized by vascular dysplasia. To the best of our knowledge, we report the first case in the literature of definite hereditary hemorrhagic telangiectasia diagnosed in western Kenya, a resource-limited setting with limited treatment options. CASE PRESENTATION: A 60-year-old black Kenyan woman was admitted 1 year ago to a hospital in western Kenya with an 11-year history of recurrent spontaneous epistaxis...
2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/26946067/tranexamic-acid-in-epistaxis-a-systematic-review
#6
Y Kamhieh, H Fox
BACKGROUND: The role of tranexamic acid in the management of epistaxis remains unclear. There is uncertainty about its safety and about the contraindications for its use. We performed a systematic review of the use of systemic and topical tranexamic acid in epistaxis and a comparative review of its use in other specialties. OBJECTIVE OF REVIEW: This review assesses and summarises the existing evidence for the efficacy and safety of tranexamic acid in the management of epistaxis...
December 2016: Clinical Otolaryngology
https://www.readbyqxmd.com/read/26681525/evaluating-three-hundred-and-fifty-two-admissions-and-predictors-of-re-admissions-for-epistaxis-is-it-time-to-re-evaluate-tranexamic-acid-in-epistaxis
#7
S Jervis, T Saunders, J Belcher, D Skinner
Epistaxis is a common indication for admission under ENT care. Such patients usually have nasal packing for a short period and social circumstances or medical co-morbidities may prevent discharge home with packs in-situ. With bed pressures and an elderly epistaxis population, these admissions are far from ideal but are unavoidable in those with significant bleeds. This article is protected by copyright. All rights reserved.
December 18, 2015: Clinical Otolaryngology
https://www.readbyqxmd.com/read/26088087/tranexamic-acid-for-epistaxis-a-promising-treatment-that-deserves-further-study
#8
COMMENT
David Clinkard, David Barbic
CLINICAL QUESTION: Does the application of topical tranexamic acid reduce bleeding as compared to anterior packing? ARTICLE CHOSEN: Zahed R, Moharamzadeh P, Alizadeharasi S, et al. A new and rapid method for epistaxis treatment using injectable form of tranexamic acid topically: a randomized controlled trial. Am J Emerg Med 2013;31(9):1389-92. OBJECTIVES: To determine if topically applied tranexamic acid reduces bleeding time in epistaxis...
January 2016: CJEM
https://www.readbyqxmd.com/read/26036756/should-anti-inhibitor-coagulant-complex-and-tranexamic-acid-be-used-concomitantly
#9
REVIEW
L A Valentino, P A Holme
Inhibitor development in haemophilia patients is challenging especially when undergoing surgical procedures. The development of an inhibitor precludes using factor VIII (FVIII) therapy thereby requiring a bypassing agent (BPA) for surgical bleeding prophylaxis if the FVIII inhibitor titre >5 BU. Concomitant use of anti-inhibitor coagulant complex (AICC) and tranexamic acid has been reported in the literature as a beneficial treatment for this population. Anti-inhibitor coagulant complex is known to cause an increase in thrombin generation and tranexamic acid inhibits fibrinolysis...
November 2015: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/25064693/the-use-of-anti-fibrinolytic-agents-in-patients-with-hht-a-retrospective-survey
#10
Nusrat Zaffar, Tharsha Ravichakaravarthy, Marie E Faughnan, Nadine Shehata
The anti-fibrinolytic agent tranexamic acid (TXA) has been used to reduce bleeding in patients with hereditary hemorrhagic telangiectasia (HHT); however, there are limited data on its efficacy and safety. We conducted a retrospective study at the HHT center, using a structured questionnaire and data abstraction to determine the safety and effectiveness of TXA. Forty-two patients from the HHT database with a definite clinical or genetic diagnosis of HHT with epistaxis and/or gastrointestinal bleeding and receiving TXA were included, and their Epistaxis Severity Score (ESS), blood transfusions, and hospitalizations prior to and during TXA use were assessed...
January 2015: Annals of Hematology
https://www.readbyqxmd.com/read/25040799/tranexamic-acid-for-epistaxis-in-hereditary-hemorrhagic-telangiectasia-patients-a-european-cross-over-controlled-trial-in-a-rare-disease
#11
RANDOMIZED CONTROLLED TRIAL
S Gaillard, S Dupuis-Girod, F Boutitie, S Rivière, S Morinière, P-Y Hatron, G Manfredi, P Kaminsky, A-L Capitaine, P Roy, F Gueyffier, H Plauchu
BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is a genetic disorder associated with abnormal angiogenesis and disabling epistaxis. Tranexamic acid (TA) has been widely used in the treatment of these severe bleeds but with no properly designed trial. OBJECTIVES: To demonstrate the efficacy of TA in epistaxis in HHT patients and to explore its safety of use. PATIENTS/METHODS: A randomized, placebo-controlled, double-blind, cross-over trial was conducted...
September 2014: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/25017453/tranexamic-acid-a-useful-drug-in-ent-surgery
#12
REVIEW
P J Robb
BACKGROUND: Tranexamic acid is a synthetic antifibrinolytic drug. It has been widely available for over 40 years, but only recently has it started to be used routinely in many surgical disciplines. For ENT surgeons, epistaxis and post-tonsillectomy bleeding contribute a significant proportion of the morbidity and emergency workload in a general ENT department. Published evidence indicates a potentially helpful role for tranexamic acid in managing epistaxis. RESULTS AND CONCLUSION: To date, the benefits of tranexamic acid as a prophylactic treatment to reduce the rate and severity of post-tonsillectomy bleeding are less certain...
July 2014: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/25005464/treatment-of-epistaxis-in-hereditary-hemorrhagic-telangiectasia-with-tranexamic-acid-a-double-blind-placebo-controlled-cross-over-phase-iiib-study
#13
RANDOMIZED CONTROLLED TRIAL
Urban W Geisthoff, Ulrich T Seyfert, Marcus Kübler, Birgitt Bieg, Peter K Plinkert, Jochem König
INTRODUCTION: Epistaxis is the most frequent manifestation in hereditary hemorrhagic telangiectasia, in which no optimal treatment exists. It can lead to severe anemia and reduced quality of life. Positive effects of tranexamic acid, an antifibrinolytic drug, have been reported on epistaxis related to this disorder. We sought to evaluate the efficacy of treating nosebleeds in hereditary hemorrhagic telangiectasia with tranexamic acid. MATERIALS AND METHODS: In a randomized, double-blind, placebo controlled, cross-over phase IIIB study, 1 gram of tranexamic acid or placebo was given orally 3 times daily for 3 months for a total of 6 months...
September 2014: Thrombosis Research
https://www.readbyqxmd.com/read/24846097/best-evidence-topic-reports-bet-3-topical-intranasal-tranexamic-acid-for-spontaneous-epistaxis
#14
REVIEW
Lee Hilton, Adam Reuben
A short-cut review was carried out to establish whether topical tranexamic acid can be used to treat spontaneous epistaxis. Thirty-three papers were found, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. The clinical bottom line is that there is insufficient evidence to support the use of topical intranasal tranexamic acid in the management of spontaneous epistaxis in haemodynamically stable patients presenting to the emergency department...
May 2014: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/24744623/rare-coagulation-disorders-a-retrospective-analysis-of-156-patients-in-turkey
#15
Tunç Fışgın, Can Balkan, Tiraje Celkan, Yurdanur Kılınç, Meral Türker, Cetin Timur, Türkiz Gürsel, Emin Kürekçi, Feride Duru, Alphan Küpesiz, Lale Olcay, Sebnem Yılmaz, Unsal Ozgen, Ayşegül Unüvar, Hale Oren, Kaan Kavaklı
OBJECTIVE: To retrospectively evaluate the clinical findings, laboratory data, management, and outcome in a group ofTurkish children diagnosed with rare coagulation deficiencies (RCDs) between January 1999 and June 2009. MATERIAL AND METHODS: The Turkish Society of Pediatric Hematology-Hemophilia-Thrombosis-Hemostasissubcommittee designed a Microsoft Excel-based questionnaire for standardized data collection and sent it to participatinginstitutions. RESULTS: In total, 156 patients from 12 pediatric referral centers were included in the study...
March 2012: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
https://www.readbyqxmd.com/read/24164872/a-self-controlled-comparative-clinical-trial-to-explore-the-effectiveness-of-three-topical-hemostatic-agents-for-stopping-severe-epistaxis-in-pediatrics-with-inherited-coagulopathies
#16
RANDOMIZED CONTROLLED TRIAL
P Eshghi, A Jenabzade, B Habibpanah
OBJECTIVE: The aim of this study was to assess the effectiveness of localized treatments to persistently stop epistaxis in patients with inherited bleeding disorders. METHODS: In a self-controlled comparative clinical trial, to offer the best solution to stop epistaxis at home (within 10 minutes), patients with inherited bleeding disorders were treated using three different topical hemostatic agents, including Tranexamic acid impregnated tampon, EpiCell tampon prepared from oxidized regenerated cellulose pad, and ChitoHem tampon (reinforced with chitosan)...
September 2014: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/23911102/a-new-and-rapid-method-for-epistaxis-treatment-using-injectable-form-of-tranexamic-acid-topically-a-randomized-controlled-trial
#17
RANDOMIZED CONTROLLED TRIAL
Reza Zahed, Payman Moharamzadeh, Saeid Alizadeharasi, Asghar Ghasemi, Morteza Saeedi
OBJECTIVE: Epistaxis is a common problem in the emergency department (ED). Sixty percent of people experience it at least once in their life. There are different kinds of treatment for epistaxis. This study intended to evaluate the topical use of injectable form of tranexamic acid vs anterior nasal packing with pledgets coated with tetracycline ointment. METHODS: Topical application of injectable form of tranexamic acid (500 mg in 5 mL) was compared with anterior nasal packing in 216 patients with anterior epistaxis presented to an ED in a randomized clinical trial...
September 2013: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/23881695/topical-application-of-tranexamic-acid-for-the-reduction-of-bleeding
#18
REVIEW
Katharine Ker, Deirdre Beecher, Ian Roberts
BACKGROUND: Intravenous tranexamic acid reduces bleeding in surgery, however, its effect on the risk of thromboembolic events is uncertain and an increased risk remains a theoretical concern. Because there is less systemic absorption following topical administration, the direct application of tranexamic acid to the bleeding surface has the potential to reduce bleeding with minimal systemic effects. OBJECTIVES: To assess the effects of the topical administration of tranexamic acid in the control of bleeding...
July 23, 2013: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/23553514/treatment-of-bleeding-upper-aerodigestive-tract-tumor-a-novel-approach-with-antifibrinolytic-agent-case-series-and-literature-review
#19
REVIEW
Tsu-Hui Hubert Low, Johnson Huang, Colin Reid, Michael Elliott, Jonathan R Clark
OBJECTIVES/HYPOTHESIS: Symptomatic bleeding among patients with advanced upper aerodigestive tract tumor is a challenging problem. Given the limited options for topical treatment, embolization is often required to control the hemorrhage. There are recent reported cases of novel and successful treatment of patients with recalcitrant tracheo-bronchial bleed with tranexamic acid. We therefore described our initial experience of four consecutive cases of patients with bleeding from advanced aerodigestive tract tumor, successfully treated with oral tranexamic acid...
October 2013: Laryngoscope
https://www.readbyqxmd.com/read/23490942/-case-15-chronic-bleeding-anemia-and-osler-s-disease
#20
Fontana, Lämmle
We report the history of a 77-year-old man with Osler-Weber-Rendu disease (hereditary hemorrhagic telangiectasia) who suffered from recurrent epistaxis and chronic bleeding anemia for many years. Hereditary hemorrhagic telangiectasia is a rare congenital disease, that is characterized by telangiectases of the nasal and oral mucosa, the gastrointestinal tract and the skin. Arteriovenous malformations of the lung and the brain may be present. The genetic and pathologic features, the clinical manifestations and the differential diagnosis are shortly presented...
September 1, 1999: Therapeutische Umschau. Revue Thérapeutique
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