Novel oral anticoagulants: pharmacology, coagulation measures, and considerations for reversal

Novel oral anticoagulants (NOAC) provide an effective and, in some cases, superior alternative to traditional, oral vitamin K antagonists such as warfarin. These drugs differ in their pharmacokinetic and pharmacodynamics profiles, which is important for selecting the right drug for the right patient...

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Bibliographic Details
Published in:Journal of thrombosis and thrombolysis 2014-04, Vol.37 (3), p.380-391
Main Authors: Jackson, Larry R., Becker, Richard C.
Format: Article
Language:English
Subjects:
Administration, Oral
Anticoagulants - adverse effects
Anticoagulants - pharmacokinetics
Anticoagulants - therapeutic use
Blood Coagulation - drug effects
Cardiology
Clinical Trials as Topic
Hematology
Hemorrhage - chemically induced
Hemorrhage - prevention & control
Humans
Medicine
Medicine & Public Health
Monitoring, Physiologic - methods
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Summary:Novel oral anticoagulants (NOAC) provide an effective and, in some cases, superior alternative to traditional, oral vitamin K antagonists such as warfarin. These drugs differ in their pharmacokinetic and pharmacodynamics profiles, which is important for selecting the right drug for the right patient. A concern among clinicians is a virtual absence of guidance from clinical trials for reversing the anticoagulant effects of these drugs in clinical settings such as life-threatening bleeding or a need for emergent procedures that carry bleeding risk. In this review, we discuss NOAC, the role of coagulation assays to assess their systemic anticoagulants effects, and the available data supporting strategies designed to reverse or attenuate these effects.
ISSN:0929-5305
1573-742X
DOI:10.1007/s11239-013-0958-0