Practical Guide for Anticoagulant and Antiplatelet Reversal in Clinical Practice
In recent years, anticoagulant and antiplatelet use have increased over the past years for the prevention and treatment of several cardiovascular conditions. Due to the rising use of antithrombotic medications and the complexity of specific clinical cases requiring such therapies, bleeding remains t...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Pharmacy |
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| Online Access: | https://www.mdpi.com/2226-4787/11/1/34 |
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| author | Mohammed Aldhaeefi Hisham A. Badreldin Faisal Alsuwayyid Tariq Alqahtani Omar Alshaya Majed S. Al Yami Khalid Bin Saleh Shmeylan A. Al Harbi Abdulrahman I. Alshaya |
| author_facet | Mohammed Aldhaeefi Hisham A. Badreldin Faisal Alsuwayyid Tariq Alqahtani Omar Alshaya Majed S. Al Yami Khalid Bin Saleh Shmeylan A. Al Harbi Abdulrahman I. Alshaya |
| author_sort | Mohammed Aldhaeefi |
| collection | DOAJ |
| description | In recent years, anticoagulant and antiplatelet use have increased over the past years for the prevention and treatment of several cardiovascular conditions. Due to the rising use of antithrombotic medications and the complexity of specific clinical cases requiring such therapies, bleeding remains the primary concern among patients using antithrombotics. Direct oral anticoagulants (DOACs) include rivaroxaban, apixaban, edoxaban, and betrixaban. Direct thrombin inhibitors (DTIs) include argatroban, bivalirudin, and dabigatran. DOACs are associated with lower rates of fatal, life-threatening, and significant bleeding risks compared to those of warfarin. The immediate reversal of these agents can be indicated in an emergency setting. Antithrombotic reversal recommendations are still in development. Vitamin K and prothrombin complex concentrate (PCCs) can be used for warfarin reversal. Andexanet alfa and idarucizumab are specific reversal agents for DOACs and DTIs, respectively. Protamine sulfate is the solely approved reversal agent for unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH). However, there are no specific reversal agents for antiplatelets. This article aims to provide a practical guide for clinicians regarding the reversal of anticoagulants and antiplatelets in clinical practice based on the most recent studies. |
| first_indexed | 2024-03-11T08:15:46Z |
| format | Article |
| id | doaj.art-640d24c7918f413fbc6f730d1df45cd6 |
| institution | Directory Open Access Journal |
| issn | 2226-4787 |
| language | English |
| last_indexed | 2024-03-11T08:15:46Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmacy |
| spelling | doaj.art-640d24c7918f413fbc6f730d1df45cd62023-11-16T22:44:04ZengMDPI AGPharmacy2226-47872023-02-011113410.3390/pharmacy11010034Practical Guide for Anticoagulant and Antiplatelet Reversal in Clinical PracticeMohammed Aldhaeefi0Hisham A. Badreldin1Faisal Alsuwayyid2Tariq Alqahtani3Omar Alshaya4Majed S. Al Yami5Khalid Bin Saleh6Shmeylan A. Al Harbi7Abdulrahman I. Alshaya8Department of Clinical and Administrative Pharmacy Sciences, Howard University College of Pharmacy, Washington, DC 20059, USAPharmaceutical Care Services, King Abdulaziz Medical Center, Riyadh 11426, Saudi ArabiaDepartment of Pharmaceutical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi ArabiaDepartment of Pharmaceutical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi ArabiaPharmaceutical Care Services, King Abdulaziz Medical Center, Riyadh 11426, Saudi ArabiaPharmaceutical Care Services, King Abdulaziz Medical Center, Riyadh 11426, Saudi ArabiaPharmaceutical Care Services, King Abdulaziz Medical Center, Riyadh 11426, Saudi ArabiaPharmaceutical Care Services, King Abdulaziz Medical Center, Riyadh 11426, Saudi ArabiaPharmaceutical Care Services, King Abdulaziz Medical Center, Riyadh 11426, Saudi ArabiaIn recent years, anticoagulant and antiplatelet use have increased over the past years for the prevention and treatment of several cardiovascular conditions. Due to the rising use of antithrombotic medications and the complexity of specific clinical cases requiring such therapies, bleeding remains the primary concern among patients using antithrombotics. Direct oral anticoagulants (DOACs) include rivaroxaban, apixaban, edoxaban, and betrixaban. Direct thrombin inhibitors (DTIs) include argatroban, bivalirudin, and dabigatran. DOACs are associated with lower rates of fatal, life-threatening, and significant bleeding risks compared to those of warfarin. The immediate reversal of these agents can be indicated in an emergency setting. Antithrombotic reversal recommendations are still in development. Vitamin K and prothrombin complex concentrate (PCCs) can be used for warfarin reversal. Andexanet alfa and idarucizumab are specific reversal agents for DOACs and DTIs, respectively. Protamine sulfate is the solely approved reversal agent for unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH). However, there are no specific reversal agents for antiplatelets. This article aims to provide a practical guide for clinicians regarding the reversal of anticoagulants and antiplatelets in clinical practice based on the most recent studies.https://www.mdpi.com/2226-4787/11/1/34pharmacistpharmacy technicianhealth promotionhealth protectionhealth improvementinterventions |
| spellingShingle | Mohammed Aldhaeefi Hisham A. Badreldin Faisal Alsuwayyid Tariq Alqahtani Omar Alshaya Majed S. Al Yami Khalid Bin Saleh Shmeylan A. Al Harbi Abdulrahman I. Alshaya Practical Guide for Anticoagulant and Antiplatelet Reversal in Clinical Practice Pharmacy pharmacist pharmacy technician health promotion health protection health improvement interventions |
| title | Practical Guide for Anticoagulant and Antiplatelet Reversal in Clinical Practice |
| title_full | Practical Guide for Anticoagulant and Antiplatelet Reversal in Clinical Practice |
| title_fullStr | Practical Guide for Anticoagulant and Antiplatelet Reversal in Clinical Practice |
| title_full_unstemmed | Practical Guide for Anticoagulant and Antiplatelet Reversal in Clinical Practice |
| title_short | Practical Guide for Anticoagulant and Antiplatelet Reversal in Clinical Practice |
| title_sort | practical guide for anticoagulant and antiplatelet reversal in clinical practice |
| topic | pharmacist pharmacy technician health promotion health protection health improvement interventions |
| url | https://www.mdpi.com/2226-4787/11/1/34 |
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