The Annals of pharmacotherapy
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Comparative Study Observational Study
Efficacy and safety of tranexamic acid versus ϵ-aminocaproic acid in cardiovascular surgery.
Blood conservation is a major concern in the management of surgical patients because of transfusion-related complications, limited supply, and health care costs. Tranexamic acid (TXA) and ϵ-aminocaproic acid (ϵACA) are lysine analogue antifibrinolytics used to reduce surgical bleeding and transfusions. ⋯ There were no differences in the efficacy and safety outcomes between TXA and ϵACA in the management of cardiovascular surgical bleeding at our institution. Considering the substantial cost difference and comparable efficacy and safety, ϵACA may have better value over TXA for reducing cardiovascular surgical bleeding.
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Patients suffering from moderate to severe serotonin syndrome frequently present with autonomic instability and altered mental status. Management of serotonin syndrome can be complex and may be refractory to treatment with benzodiazepines alone. The objective of this series is to present 3 cases of serotonin syndrome that demonstrated clinical improvement with initiation of dexmedetomidine. ⋯ Accordingly, health care providers may consider using dexmedetomidine as adjunctive therapy for cases of severe serotonin syndrome that are refractory to standard treatment.