Anticoagulants - NOACs

Question 1

Commonly used drugs

Answer 1

Apixaban

Dabigatran

Rivaroxaban

Question 2

How do they work?

Answer 2

DabigaTran = Thrombin inhibitor

ApiXaban and RivaroXaban = Factor Xa inhibitors

Question 3

Indications

Answer 3

Treatment of newly diagnosed DVT or PE. Unlike with warfarin, covering w/ heparin for first few days in not required.

AF where CHA2-DS2-VASc score suggests need for anticoagulation.

Prevention of VTE after surgery

NB - NOACs supersede warfarin for AF and VTE

Question 4

Contraindications

Answer 4

Valvular heart disease or mechanical valve

Renal failure (CrCl <30)

Liver failure

Active bleeding or history of bleeding disorder

Pregnancy or breast feeding

Question 5

Reversal

Answer 5

Reversal difficult, unlike for warfarin

Reversal agent for dabigatran, but not the other two.