Therapeutic approach to the bleeding in association with "old" and "new" anticoagulants

There are a several new anticoagulants emerging in the clinical medicine in the last a few years. Rivaroxaban, an oral direct F Xa inhibitor has been already approved in more than 100 countries worldwide, and Dabigatran etexilate, an oral direct thrombin inhibitor is also routinely used in thromboprophylaxis of venous thromboembolism. These agents possess many of the characteristic of the "ideal" anticoagulant but a lack of specific antidotes may be a potentional disadvantage in the therapy of bleeding complications. We assume, this lack of antidote does not represent a significant problem. In comparison with established anticoagulants (unfractionated heparin - UFH, low molecular weight heparin - LMWH, vitamin K antagonists - VKAs), only UFH has a specific and affective reversal agent. LMWH does not have the full proven antidote and the reversal agents recommended for the effects of VKAs have several safety and practical limitations. In the article we propose the basic principles of the management of bleeding complications in association with the newer anticoagulans. To manage bleeding episodes, we recommend delaying the next dose or discontinuing of treatment, mechanical compression, surgical interventions and the administration of the blood products. In the case of life-threatening bleeding, Novosen - rF VII is indicated.

Medienart:

Artikel

Erscheinungsjahr:

2012

Erschienen:

2012

Enthalten in:

Zur Gesamtaufnahme - volume:58

Enthalten in:

Vnitrni lekarstvi - 58(2012), 7-8 vom: 24. Juli, Seite 559-63

Sprache:

Tschechisch

Weiterer Titel:

Terapeutický přístup ke krvácení v souvislosti se "starými" a "novými" antikoagulans

Beteiligte Personen:

Dulíček, P [VerfasserIn]

Themen:

9005-49-6
9NDF7JZ4M3
Anticoagulants
Benzimidazoles
Dabigatran
English Abstract
Heparin
Heparin, Low-Molecular-Weight
I0VM4M70GC
Journal Article
Morpholines
Pyridines
Review
Rivaroxaban
Thiophenes

Anmerkungen:

Date Completed 13.12.2012

Date Revised 19.11.2015

published: Print

Citation Status MEDLINE

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM221837728