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Tranexamic Acid Mechanism — ORE Part 1 MCQ

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ModeratePharmacology & TherapeuticsTranexamic Acid MechanismORE Part 1

A patient with a bleeding disorder is prescribed tranexamic acid mouthwash after dental extraction. Which action best describes how tranexamic acid reduces postoperative bleeding?

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Correct answer: BCompetitively inhibits conversion of plasminogen to plasmin

**A is correct.** Tranexamic acid is an antifibrinolytic: it competitively inhibits activation of plasminogen to plasmin. As plasmin mediates fibrin degradation, this reduces fibrinolysis and helps preserve the extraction-site clot. This is the relevant mechanism whether tranexamic acid is used systemically or topically as a mouthwash. **B** concerns primary haemostasis; tranexamic acid does not increase platelet adhesion or aggregation. **C** would enhance coagulation-factor activation, whereas tranexamic acid does not activate the intrinsic or common coagulation pathways. **D** describes the action of a vasoconstrictor, not an antifibrinolytic. **E** describes a local haemostatic dressing; tranexamic acid acts biochemically rather than by forming a physical barrier.

Reference: Sovereign Medical. Tranexamic Acid 500 mg Tablets: Summary of Product Characteristics, section 5.1 Pharmacodynamic properties. Revised 08 April 2026. https://www.medicines.org.uk/emc/product/14622/smpc