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Epistaxis

Epistaxis

Epistaxis, or nosebleeds, occurs when small, swollen blood vessels in the nasal mucous membrane rupture. Typically, the anterior septum is the primary site of occurrence.
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...

Spontaneity

Spontaneity

A spontaneous process is one that occurs naturally under certain conditions. A nonspontaneous process, on the other hand, will not take place unless it is “driven” by the continual input of energy from an external source. Processes have a natural tendency to occur in one direction under a given set of conditions. Water will naturally flow downhill (spontaneous process), but uphill flow (nonspontaneous process) requires outside intervention such as the use of a pump. Iron exposed to...

Spontaneous and Induced Mutations

Spontaneous and Induced Mutations

Spontaneous mutations arise infrequently during DNA replication due to errors in the process. A key factor behind these errors is tautomeric shifts in nitrogenous bases, where bases transition from keto to enol forms or amino to imino forms. This shift can alter base-pairing rules, leading to mutations. Additionally, reactive oxygen species (ROS) arising from aerobic metabolism can damage DNA, resulting in depurination (loss of a purine base) or depyrimidination (loss of a pyrimidine base).

Amino acids

Amino acids

Amino acids are the monomers that comprise proteins. Each amino acid has the same fundamental structure, which consists of a central carbon atom, or the alpha (α) carbon, bonded to an amino group (NH2), a carboxyl group (COOH), and to a hydrogen atom. Every amino acid also has another atom or group of atoms bonded to the central atom known as the R group. There are 20 common amino acids present in proteins, each with a different R group. Variation in the amino acid sequence is responsible for...

Polyprotic Acids

Polyprotic Acids

Acids are classified by the number of protons per molecule that they can give up in a reaction. Acids such as HCl, HNO3, and HCN that contain one ionizable hydrogen atom in each molecule are called monoprotic acids. Their reactions with water are:

Mixtures of Acids

Mixtures of Acids

The pH of a solution containing an acid can be determined using its acid dissociation constant and its initial concentration. If a solution contains two different acids, then its pH can be determined using one of several methods depending upon the relative strength of the acids and their dissociation constants.
A Mixture of a Strong Acid and a Weak Acid
In a mixture of a strong acid and a weak acid, the strong acid dissociates completely and becomes a source of almost all the hydronium ions...

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Related Experiment Video

Updated: Feb 1, 2026

Author Spotlight: Non-Surgical Treatment of Melasma– Microneedling with Tranexamic Acid

Author Spotlight: Non-Surgical Treatment of Melasma– Microneedling with Tranexamic Acid

Published on: January 19, 2024

Topical tranexamic acid for spontaneous epistaxis.

María Jesús Santander¹, Andrés Rosenbaum², Matías Winter³

¹Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile.

|December 15, 2018

Summary

Topical tranexamic acid is a potential treatment for spontaneous epistaxis (nosebleeds). However, current evidence is very low certainty, making its effectiveness and impact on adverse events unclear.

Keywords:

Epistemonikos GRADE epistaxis tranexamic acid

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Published on: January 13, 2017

Area of Science:

Otorhinolaryngology
Emergency Medicine
Pharmacology

Background:

Spontaneous epistaxis is a common emergency department presentation.
Topical tranexamic acid is an emerging treatment option.
The efficacy of topical tranexamic acid for epistaxis remains debated.

Purpose of the Study:

To evaluate the efficacy of topical tranexamic acid in managing spontaneous epistaxis.
To assess the risk of rebleeding and adverse effects associated with topical tranexamic acid.
To synthesize evidence from systematic reviews on this treatment.

Main Methods:

Systematic search of the Epistemonikos database, including MEDLINE, EMBASE, and Cochrane.
Data extraction from systematic reviews.
Meta-analysis of primary study data.
Application of the GRADE approach for certainty of evidence assessment.

Main Results:

Five systematic reviews were identified, each analyzing a single primary randomized trial.
The certainty of evidence regarding the impact of topical tranexamic acid on hemostasis is very low.
The effect on rebleeding risk and potential adverse effects is uncertain due to low-certainty evidence.

Conclusions:

There is insufficient high-quality evidence to confirm the effectiveness of topical tranexamic acid for epistaxis.
The potential for increased adverse effects with topical tranexamic acid warrants further investigation.
More rigorous research is needed to clarify the role of topical tranexamic acid in epistaxis management.