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9780521704632c23 CUFX213A/Peck 9780521618168 December 29, 2007 14:58
Section IVOther important drugscomplex. In addition it has been suggested that it preserves platelet function and
decreases activation of the clotting cascade.
Ithas been used for the treatment of haemorrhage due to hyperplasminaemia at a
dose of 500 000–1 000 000 units followed by 200 000 units per hour until the bleeding
stops.
Ithas also been used in patients at high risk of bleeding during and after cardiopul-
monary bypass. The dose here is 2 000 000 prior to sternotomy followed by 500 000
units per hour. In addition, 2 000 000 units is added to the cardiopulmonary bypass
machine.Side effects
Hypersensitivity reactions including anaphylaxis.
Coagulation – it prolongs the activated clotting time (ACT) of heparinized blood
so that heparin/protamine protocols will need alteration during treatment with
aprotinin.Kinetics
Aprotinin is metabolized and eliminated by the kidney.
Tranexamic acidcompetitively inhibits the conversion of plasminogen to active
plasmin. It is used to control bleeding due to excessive fibrinolysis, which may be
local (prostatectomy or surgical procedures in haemophiliacs) or systemic (following
intravenous fibrinolytic therapy or DIC). It is excreted essentially (95%) unchanged
in the urine.