» Articles » PMID: 24969622

Emergency Reversal of Anticoagulation: Novel Agents

Overview
Specialty Neurology
Date 2014 Jun 28
PMID 24969622
Citations 6
Authors
Affiliations
Soon will be listed here.
Abstract

Historically, oral anticoagulation involved the administration of vitamin K antagonists, such as warfarin. However, because of the need for frequent monitoring and the desire for safer anticoagulants, several novel oral anticoagulants have been developed. These newer agents include the factor Xa inhibitors (eg, rivaroxaban, apixaban, edoxaban), along with the direct thrombin inhibitors (eg, dabigatran). This manuscript provides a brief overview of their uses and mechanisms of action, along with a review of currently available evidence for reversal strategies when life-threatening bleeding occurs.

Citing Articles

Risk Factors for Pulmonary Embolism in ICU Patients: A Retrospective Cohort Study from the MIMIC-III Database.

Huang C, Hong C, Xu T, Zhao D, Wu Z, Chen L Clin Appl Thromb Hemost. 2022; 28:10760296211073925.

PMID: 35043708 PMC: 8796081. DOI: 10.1177/10760296211073925.


Direct-Acting Oral Anticoagulants and Their Reversal Agents-An Update.

Kustos S, Fasinu P Medicines (Basel). 2019; 6(4).

PMID: 31618893 PMC: 6963825. DOI: 10.3390/medicines6040103.


Diagnosis and Management of Acute Intracerebral Hemorrhage.

Morotti A, Goldstein J Emerg Med Clin North Am. 2016; 34(4):883-899.

PMID: 27741993 PMC: 5089075. DOI: 10.1016/j.emc.2016.06.010.


New Oral Anticoagulants and Their Reversal Agents.

Morotti A, Goldstein J Curr Treat Options Neurol. 2016; 18(11):47.

PMID: 27696178 DOI: 10.1007/s11940-016-0430-5.


Anticoagulation drug therapy: a review.

Harter K, Levine M, Henderson S West J Emerg Med. 2015; 16(1):11-7.

PMID: 25671002 PMC: 4307693. DOI: 10.5811/westjem.2014.12.22933.


References
1.
Schiele F, van Ryn J, Canada K, Newsome C, Sepulveda E, Park J . A specific antidote for dabigatran: functional and structural characterization. Blood. 2013; 121(18):3554-62. DOI: 10.1182/blood-2012-11-468207. View

2.
Hillarp A, Baghaei F, Fagerberg Blixter I, Gustafsson K, Stigendal L, Sten-Linder M . Effects of the oral, direct factor Xa inhibitor rivaroxaban on commonly used coagulation assays. J Thromb Haemost. 2010; 9(1):133-9. DOI: 10.1111/j.1538-7836.2010.04098.x. View

3.
Lee C, Ansell J . Direct thrombin inhibitors. Br J Clin Pharmacol. 2011; 72(4):581-92. PMC: 3195735. DOI: 10.1111/j.1365-2125.2011.03916.x. View

4.
van Ryn J, Stangier J, Haertter S, Liesenfeld K, Wienen W, Feuring M . Dabigatran etexilate--a novel, reversible, oral direct thrombin inhibitor: interpretation of coagulation assays and reversal of anticoagulant activity. Thromb Haemost. 2010; 103(6):1116-27. DOI: 10.1160/TH09-11-0758. View

5.
Dinkelaar J, Molenaar P, Ninivaggi M, de Laat B, Brinkman H, Leyte A . In vitro assessment, using thrombin generation, of the applicability of prothrombin complex concentrate as an antidote for Rivaroxaban. J Thromb Haemost. 2013; 11(6):1111-8. DOI: 10.1111/jth.12236. View