ANTICOAGULANTS

Question 1

What type of drug is a DOAC?

What factors do they inhibit?

Answer 1

DIRECT ORAL ANTICOAGULANT

Rivoroxaban, apixaban and edoxaban all inhibit Xa

Dabigatran inhibits thrombin

Question 2

What is the regime for all DOACS?

Answer 2

Apixaban or dabigatran are taken twice daily

Rivaroxaban is taken one in morning

Edoxaban is taken once in evening

Question 3

What drug is warfarin?

Answer 3

Vitamin K antagonist

Question 4

Give some anti platelet drugs

Answer 4

Aspirin

Clopidogrel

Dipyridamole

Question 5

What to do for low bleeding risk and on DOAC

Answer 5

Non interference with drug regime

Question 6

High bleeding risk and on DOAC, what do?

Answer 6

Apixaban and dabigatran = miss morning dose

Rivoroxiban = delay morning dose

Edoxaban = take so long as 4 hours after haemostasis

Question 7

What to do if on warfarin?

Answer 7

Check INR and should be between 2-4

Question 8

What to do if on low dose prophylactic IV anticoagulant

High dose?

Answer 8

Treat without interrupt

High dose = consult prescribing clinician

Question 9

What to do on aspirin alone for drug regime?

Answer 9

Treat without interrupting medication

• consider limiting initial area and staging extractions

Question 10

What to do on aspirin + clopidogrel etc

Answer 10

Treat without interruption but expect prolonged bleeding

Limit initial area and stage treatment

Question 11

What to do if on anticoagulant + anti platelet

Answer 11

Consult with prescribing clinician