Epsilon-aminocaproic acid therapy for dental extractions in haemophiliacs.

Cooksey, M. W.; Perry, Clifton; Raper, A. B.

doi:10.1136/bmj.2.5530.1633

Cited by 26 publications

(9 citation statements)

References 7 publications

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“…It has been reported that fibrinolytic activity in patients with hemophilia A is increased (1,2) and that e-aminocaproic acid is effective in reducing the incidence of hemorrhage (2) and also hemostasis after dental extraction in such patients (3). However, other reports claim that c-aminocaproic acid is not effective in reducing the incidence or severity of hemorrhage (4).…”

Section: Introductionmentioning

confidence: 73%

Studies of the Metabolism and Distribution of Fibrinogen in Patients with Hemophilia A*

Takeda¹,

Chen²

1967

J. Clin. Invest.

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Abstract. Using autologous ""1I-fibrinogen, we made studies of the metabolism and distribution of fibrinogen in 10 patients with hemophilia A. In two patients simultaneous studies of autologous 13I-fibrinogen and homologous 125I-fibrinogen prepared from healthy donors' plasma were carried out. The average value for the plasma volume was 42.1 ± 8.8 ml/kg; for the plasma fibrinogen concentration, 349 + 90 mg/100 ml; for the intravascular fibrinogen, 144 ± 32 mg/kg; for the interstitial fibrinogen, 30 ± 11 mg/kg; for the slower half-life of 11I-fibrinogen, 2.34 + 0.17 days; for the transcapillary transfer rate of fibrinogen, 109 + 37 mg/kg per day; and for the catabolic and synthetic rates of fibrinogen, 51.7 + 13.1 mg/kg per day. Comparison of these results with those of the previous study in healthy male subjects showed that in patients with hemophilia A the catabolic and synthetic rates of fibrinogen are markedly increased, whereas the plasma fibrinogen concentration, intravascular and interstitial fibrinogen, and the transcapillary transfer rate of fibrinogen are not significantly different. The simultaneous studies of autologous 131I-fibrinogen and normal homologous 125I-fibrinogen in two subjects revealed that the two preparations behaved very similarly. Based on these findings, we concluded that our present findings are not due to the qualitative difference between the hemophilia A and normal fibrinogens, but that they are due to the difference in the host condition with respect to the fibrinogen metabolism, which is either an increased rate of direct breakdown of fibrinogen or an increased rate of fibrinogen breakdown after fibrin formation, or both.

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Section: Introductionmentioning

confidence: 73%

Studies of the Metabolism and Distribution of Fibrinogen in Patients with Hemophilia A*

Takeda¹,

Chen²

1967

J. Clin. Invest.

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“…Antifibrinolytic therapy has been used to improve hemostasis in thrombocytopenic patients [1,2] and in patients with coagula tion defects [3,6]. This study examined the influence of a single oral dose of the EACA on primary hemostasis.…”

Section: Discussionmentioning

confidence: 99%

“…Antifibrinolytic therapy with agents such as e-aminocaproic acid (EACA) has been re ported to decrease thrombocytopenic bleed ing [1][2][3]. In addition, this drug has been used as an adjunctive measure in the man agement of patients with coagulopathies, es pecially hemophilia [3][4][5][6] through dental surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, this drug has been used as an adjunctive measure in the man agement of patients with coagulopathies, es pecially hemophilia [3][4][5][6] through dental surgical procedures. On the other hand, large doses (>24g/24 h) have been shown to af fect platelet function adversely and to pro long the bleeding time in a delayed fashion in normal individuals [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Effects of Epsilon Aminocaproic Acid on Primary Hemostasis

Zeigler¹

1991

Pathophysiol Haemos Thromb

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These studies examined the effect of an oral dose of ε-aminocaproic acid (EACA) on primary hemostasis. Bleeding time tests (with and without the use of a blood pressure cuff) were measured before and 2 h following EACA in 56 patients with mild bleeding disorders and/or thrombocytopenia. Preliminary studies evaluated the reproducibility of these tests in 13 patients who had bleeding times (cuff) ranging from 8.0 to > 20 min. Their replicate bleeding time values with cuff agreed within 2.5 min and those without cuff within 3 min. Therefore, the 56 study patients were considered to have had no change in their bleeding times after EACA, if their bleeding time with cuff was ± 2.5 min and/or their nonoccluded value was ± 3 min of their baseline values, respectively. An isolated increase in bleeding times was observed in 6 of 56 (11 %) patients. All 6 had myelodysplasia associated with long bleeding times; their nonoccluded values increased by 5–14 min. Of the 56 study patients, 54% showed a decrease in their bleeding times following EACA. The changes were evident with venostasis in 18 of 30 (60 %) and without venostasis in 12 (40%) patients. These studies suggest that EACA may improve primary hemostasis in some patients with prolonged bleeding times.

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“…For extractions EACA has proved very useful when associated with other topical therapy [1,6,9,15,16]. It has recently been pointed out that by administering EACA in doses of 0.4 g/kg/day for 6-8 days after dental extraction it is possible to avoid substitutive therapy with fresh frozen plasma or with cryoprecipitates [1].…”

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confidence: 99%

Epsilon-Aminocaproic Acid for Synovectomy in Haemophilic Patients

et al. 1972

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The study of coagulation and fibrinolysis in synovectomised haemophilic patients, treated by a new haemostatic combined therapy, is reported. This treatment is based on a combination of replacement therapy (fresh frozen plasma and/or cryoprecipitates) and ε-aminocaproic acid; the replacement therapy is continued for only 6 days, beginning on the day of operation. Our combined therapy scheme promotes a more efficient haemostasis than substitutive therapy alone and allows a considerable saving in plasma or plasma fractions.

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Epsilon-aminocaproic acid therapy for dental extractions in haemophiliacs.

Cited by 26 publications

References 7 publications

Studies of the Metabolism and Distribution of Fibrinogen in Patients with Hemophilia A*

Studies of the Metabolism and Distribution of Fibrinogen in Patients with Hemophilia A*

Effects of Epsilon Aminocaproic Acid on Primary Hemostasis

Epsilon-Aminocaproic Acid for Synovectomy in Haemophilic Patients

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