A patient with epistaxis and a history of hemophilia A is admitted to the unit and is scheduled for replacement therapy. The nurse should prepare to administer
a. tranexamic acid (Cyklokapron).
b. aminocaproic acid (Amicar).
c. desmopressin (Stimate).
d. factor VIII.
ANS: D
The cornerstone of treatment for hemophilia A is replacement therapy with factor VIII.
Tranexamic acid and aminocaproic acid are antifibrinolytic agents that act primarily by preventing the formation of plasmin from its precursor.
Desmopressin promotes the release of factor VIII from the vascular endothelium and has the advantage of being cheaper than factor VIII. Also, it can be administered by nasal spray as well as by IV infusion. However, repeated use of desmopressin can deplete stored factor VIII.
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