Influence of Tranexamic Acid on Inflammatory Signaling in Trauma

2020 ◽  
Vol 46 (02) ◽  
pp. 183-188
Author(s):  
Christopher D. Barrett ◽  
Yi Wen Kong ◽  
Michael B. Yaffe
Keyword(s):  
Tranexamic Acid ◽  
Inflammatory Responses ◽  
Traumatic Injury ◽  
Essential Medicines ◽  
World Health ◽  
Trauma Patients ◽  
Inflammatory Signaling ◽  
Inflammatory Signals ◽  
The World ◽  
Available Lysine

AbstractPlasmin generation in trauma patients has wide-ranging effects, from breakdown of clots to remodeling the extracellular matrix. An evolving recognition of plasmin as a critical effector molecule in various inflammatory signals and pathways has rendered the study of plasmin(ogen) and its regulation by upstream activators and downstream targets and inhibitors key to understanding the inflammatory responses to trauma. Tranexamic acid, a widely available lysine analogue medication on the World Health Organization's list of essential medicines, has rapidly become one of the most commonly implemented adjunct treatments for bleeding after traumatic injury in clinical practice. In this article, we review the effects, both anti- and proinflammatory, of tranexamic acid, with a focus on the injured trauma patient.

scholarly journals The use of tranexamic acid in reducing bleeding complications

2016 ◽  
Vol 3 (2) ◽  
pp. 62-70 ◽  
Author(s):  
Steve Chaplin
Keyword(s):  
Tranexamic Acid ◽  
Binding Sites ◽  
Trauma Surgery ◽  
Evidence Base ◽  
Essential Medicines ◽  
World Health ◽  
Bleeding Complications ◽  
Bleeding Disorders ◽  
The World ◽  
Tissue Plasminogen

Abstract Tranexamic acid inhibits fibrinolysis by competitively blocking the lysine binding sites of plasminogen, inhibiting binding between fibrin and plasminogen, and activation of plasminogen. It also competitively inhibits tissue plasminogen activator and inhibits plasmininduced platelet activation. The synthesis of tranexamic acid was first reported in 1962. It is used to treat or prevent excessive blood loss from trauma, surgery, and in various medical conditions including haemophilia and heavy menstrual bleeding. As a medicine affecting coagulation, it is listed in the World Health Organization’s List of Essential Medicines. Tranexamic acid remains a versatile and inexpensive agent with potential benefit in health services from the lowest to highest income countries. This pharmacy review focuses on the evidence base to support the use of tranexamic acid in acquired and inherited bleeding disorders to reduce bleeding complications.

scholarly journals Prehospital resuscitation

2021 ◽  
Vol 6 (1) ◽  
pp. e000729
Author(s):  
Alexandra M P Brito ◽  
Martin Schreiber
Keyword(s):  
Young People ◽  
Tranexamic Acid ◽  
New Technologies ◽  
Blood Product ◽  
Traumatic Injury ◽  
Trauma Patients ◽  
Blood Products ◽  
Front Line ◽  
The Usa ◽  
Review Current

Traumatic injury is the leading cause of death in young people in the USA. Our knowledge of prehospital resuscitation is constantly evolving and is often informed by research based on military experience. A move toward balanced blood product resuscitation and away from excessive crystalloid use has led to improvements in outcomes for trauma patients. This has been facilitated by new technologies allowing more front-line use of blood products as well as use of tranexamic acid in the prehospital setting. In this article, we review current practices in prehospital resuscitation and the studies that have informed these practices.

scholarly journals ‘Choking the national demos’: research partnerships and the material constitution of global health

2021 ◽  
Vol 17 (1) ◽  
pp. 122-127
Author(s):  
John Harrington
Keyword(s):  
Human Rights ◽  
Global Health ◽  
Access To Medicines ◽  
Functional Health ◽  
Essential Medicines ◽  
World Health ◽  
Moral Principle ◽  
International Human Rights Law ◽  
Health Law ◽  
The World

By foregrounding a widened view of the rule of law in transnational legal processes, the works under discussion in this symposium can support innovative critical perspectives on global health law –a field that has gained wide attention due to the spread of COVID-19 around the world (Lander, 2020; Bhatt, 2020). Legal and socio-legal scholars in the decade and a half before the pandemic worked on locating global health law and articulating its underlying principles. Lawrence Gostin's 2014 monograph offers a synoptic view centred on international institutions (e.g. the World Health Organization, World Trade Organization, UN Human Rights Council) and problems (e.g. infectious-disease response, tobacco control), along with an elaboration of its normative basis in universal moral principle and international human rights law (Gostin, 2014). Struggles over access to essential medicines and intellectual property in the early 2000s are, for example, represented in terms of the right to health constraining international trade law. Andreas Fischer-Lescano and Guenther Teubner's 2004 reading is oriented more by social theory than by doctrinal or ethical frames (Fischer-Lescano and Teubner, 2004, pp. 1006, 1008). A functional health regime has ‘differentiated out’, they observe, and operates as a discrete communication system across borders, albeit one that is threatened by the preponderant economic system. On this model, the battle for access to medicines amounts to ensuring, via human rights guarantees, that the rationality of the health system is not replaced by that of its economic rival in legal and policy communications (Fischer-Lescano and Teubner, 2004, pp. 1030, 1046).

scholarly journals A critical comparison between the World Health Organization list of essential medicines for children and the Brazilian list of essential medicines (Rename)

2013 ◽  
Vol 89 (2) ◽  
pp. 171-178
Author(s):  
Helena Lutéscia L. Coelho ◽  
Luís Carlos Rey ◽  
Marina S.G. de Medeiros ◽  
Ronaldo A. Barbosa ◽  
Said G. da Cruz Fonseca ◽  
...  
Keyword(s):  
World Health Organization ◽  
Essential Medicines ◽  
World Health ◽  
Critical Comparison ◽  
The World ◽  
Health Organization ◽  
Medicines For Children

scholarly journals Electrochemical design of a new nanosensor based on cobalt nanoparticles, chitosan and MWCNT for the determination of daclatasvir: a hepatitis C antiviral drug

RSC Advances ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 1118-1126 ◽  
Author(s):  
Shereen M. Azab ◽  
Amany M. Fekry
Keyword(s):  
Hepatitis C ◽  
Health System ◽  
Antiviral Drug ◽  
Cobalt Nanoparticles ◽  
Essential Medicines ◽  
World Health ◽  
Spectroscopic Methods ◽  
Basic Health ◽  
The World

Daclatasvir (DAC) is listed on the World Health Organization's list of essential medicines needed in a basic health system, therefore, electrochemical and impedance spectroscopic methods are necessary.

Tranexamic Acid Treatment for Trauma Victims

2021 ◽  
Author(s):  
Ian Roberts ◽  
Amy Brenner ◽  
Haleema Shakur-Still
Keyword(s):  
Tranexamic Acid ◽  
Traumatic Injury ◽  
Low Risk ◽  
Baseline Risk ◽  
Trauma Patients ◽  
Wide Range ◽  
Risk Patients ◽  
Polytrauma Patients ◽  
Time Critical ◽  
Proportional Reduction

AbstractWorldwide, traumatic injury is responsible for over 5 million deaths per year, the majority due to exsanguination and head injury. The antifibrinolytic drug tranexamic acid is the only drug proven to reduce deaths after traumatic injury. Several large randomized controlled trials have provided high-quality evidence of its effectiveness and safety in trauma patients. Early tranexamic acid reduces deaths on the day of the injury in polytrauma patients and patients with isolated traumatic brain injury by around 20%. Treatment is time critical; for patients to benefit, tranexamic acid must be given as soon as possible after injury. Intramuscular administration is well tolerated and rapidly absorbed, with the potential to reduce time to treatment. Because the proportional reduction in bleeding death with tranexamic acid does not vary by baseline risk, a wide range of trauma patients stands to benefit. There are far more low-risk trauma patients than high-risk patients, with a substantial proportion of bleeding deaths in the low-risk group. As such, treatment should not be limited to patients with severe traumatic hemorrhage. We must give paramedics and physicians the confidence to treat a far wider range of trauma patients while emphasizing the importance of early treatment.

Agile stockpiles an insurance for drug supply

2020 ◽  
pp. 4-17
Author(s):  
Eddy Gilissen ◽  
◽  
Chris Mulligan ◽  
Simon Tottman ◽  
Per Troein ◽  
...  
Keyword(s):  
Public Health ◽  
Public Service ◽  
Healthcare Systems ◽  
Essential Medicines ◽  
World Health ◽  
Catastrophic Event ◽  
Health Organizations ◽  
Safety Stock ◽  
The World ◽  
Additional Burden

Healthcare systems across the world are looking at ways of maintaining the continuity of supply of medicines to patients in times of crisis.Whilst this is not a new phenomenon, the additional burden placed on the supply chain during COVID-19 has meant it has come more into the spotlight. The need to use a stockpile can be caused by an interruption to supply, a rapid and unexpected peak in demand, or when both an interruption to supply and a peak in demand occur simultaneously. The objectives of a stockpile will guide the portfolio breadth and depth to be held. Stockpile objectives are broadly driven either by government requirements to protect public health or by organisations seeking toachieve commercial gain. These drivers are not mutually exclusive as in the case of holding safety stock and Public Service Obligation stock. An Emergency Stockpile is Public Health driven and held in order to supply essential medicines during a signifcant or catastrophic event. Emergency stockpiles can be split into three categories — preparation for imminent event, disease specifc response and general contingency stockpiles. Governments and authorities determine which products and volumes should be held in an emergency stockpile which may be guided by the World Health Organizations (WHO) l ist of essential medicines.

Rational and Irrational Drug Use: Factors, Impacts and Strategies to Combat Irrational Drug Use: A Narrative Review

2021 ◽  
Vol 2 (1) ◽  
pp. 6-17
Author(s):  
Zahra Hassan AL Qamariat ◽  
Keyword(s):  
Drug Use ◽  
Health System ◽  
Essential Medicines ◽  
World Health ◽  
Local Health ◽  
Rational Drug Use ◽  
Inappropriate Use ◽  
Rational Drug ◽  
The World ◽  
Health Organization

Misuse of drugs is a serious health problem all around the world. Rational drug use can be characterized as follows: patients receive drugs that meet their clinical needs, at doses that meet their requirements, promptly and at the lowest cost to themselves and their region. Drug abuse, polypharmacy, and misuse are the most prominent drug use problems today. Misuse of drugs can occur for a variety of reasons at different levels, including recommended mistakes and over-the- counter medications. Inappropriate use of income can lead to real negative benefits and financial results. There are many irrational drug mixtures available. Appropriate rational use of medicines will increase personal satisfaction and lead to better local health services. A list of essential medicines recommended by the World Health Organization (WHO) can assist the countries around the globe in rationalizing the distribution and purchasing of medicines, thus decreasing the costs to healthcare systems. Irrational drug use has been a subject of concern for years as it affects the health system and patients badly. Irrational use of drugs can result from several factors such as patient, prescriber, dispenser, health system, supply system, or regulations. Thus, diverse strategies have been used to promote rational drug use and also to tackle irrational use. Thereby the concept of rational and irrational drug use and factors that lead to either result should be identified and monitored.

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