You have been asked to standardize the use of tranexamic acid (TXA) in patients undergoing elective hip and knee arthroplasty at your hospital. Based on new multidisciplinary guidelines for the use of TXA in patients undergoing primary joint arthroplasty, which of the following recommendations is most appropriate?

TXA is a lysine analog that inhibits fibrinolysis by blocking the binding of plasminogen to fibrin. By reducing the ability of the plasminogen-plasmin complex to break down fibrin clots, the fibrin is stabilized and therefore favors clot formation and the reduction of bleeding. It is about 10 times more potent than aminocaproic acid, which acts in a similar fashion.

Recently, the American Society of Regional Anesthesia and Pain Medicine collaborated with three orthopedic societies to develop practice guidelines for administering TXA in elective hip and knee total joint arthroplasty (TJA). The use of TXA has been proven to reduce bleeding after hip and...

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