Anticoagulants serve as the primary strategy for the prevention and treatment of both arterial and venous thromboembolism. Anticoagulants disrupt coagulation by interfering at various points in the coagulation cascade. This class of medications does not lyse clots that already exist; rather, it prevents thrombus formation and prevents or slows the extension of an existing clot. For decades, the standard therapy for patients requiring oral anticoagulation was warfarin. However, due to some of the shortcomings of warfarin, including the need for continuous routine monitoring, longtime onset and offset of anticoagulation effect, major food and drug interactions, and high incidence of bleeding, newer agents, termed direct oral anticoagulants, or DOACs were developed. This article will provide a review of clinically important information regarding the most commonly used anticoagulants and their reversal agents.
Kayla Myers, PharmD, MPH, PGY2 Emergency Medicine Pharmacy Resident, Rosalind Franklin University of Medicine and Science and Northwestern Memorial Hospital, Chicago, IL.
Abbie Lyden, PharmD, BCPS, Emergency Medicine Clinical Pharmacist, Northwestern Memorial Hospital, and Associate Professor, Rosalind Franklin University of Medicine and Science, Chicago, IL. She also serves as the residency director for the PGY2 Emergency Medicine Pharmacy residency program at Rosalind Franklin University/Northwestern Memorial Hospital.
The authors and planners have disclosed no conflicts of interest, financial or otherwise.