Specific treatment of bleeding is frequently not feasible, because in many clinical situations bleeding is the result of multiple and complex defects of hemostasis, or because no cause can be identified. In these situations, non-transfusional agents that potentiate hemostasis may help to stop bleeding. Hemostatic agents may also be needed to meet religious requests to avoid blood transfusion (i.e., by Jehovah's witnesses). Finally, they may be needed prophylactically, when surgical operations are routinely accompanied by large blood losses that require multiple transfusions that carry a risk of transmitting bloodborne infections agents. Interest in the pharmacological reduction of bleeding rapidly increased in the 1980's, when it was recognized that the acquired immunodeficiency syndrome could result from transfusion of blood contaminated with the human immunodeficiency virus. A number of pharmacological agents have been claimed to have hemostatic properties, but only a few of them are of proven clinical value. This article reviews the clinical indications of synthetic antifibrinolytic amino acids (epsilon-aminocaproic acid and tranexamic acid), aprotinin, desmopressin and conjugated estrogens.
|Translated title of the contribution||Hemostatic drugs|
|Number of pages||9|
|Journal||Annali Italiani di Medicina Interna|
|Publication status||Published - 1997|
ASJC Scopus subject areas
- Internal Medicine