3 Direct Oral Anticoagulants Free Online FlashCards

Which clotting factor does dabigatran directly inhibit?

Dabigatran directly inhibits thrombin, also called factor IIa, which limits clot formation.

Which direct oral anticoagulants inhibit factor Xa?

Apixaban, rivaroxaban, and edoxaban directly inhibit factor Xa.

What are common uses of direct oral anticoagulants?

Depending on the drug and patient, they can prevent stroke in nonvalvular atrial fibrillation, treat or prevent recurrent DVT and PE, and prevent clots after certain orthopedic surgeries.

Can direct oral anticoagulants be substituted milligram for milligram?

No. Their indications and dosing differ by drug, so direct oral anticoagulants are not interchangeable milligram for milligram.

Which direct oral anticoagulants require initial parenteral anticoagulation for acute DVT or PE?

For acute DVT or PE, dabigatran and edoxaban are started after an initial course of parenteral anticoagulation.

Which agents can start acute DVT or PE treatment without an initial parenteral course?

Apixaban and rivaroxaban have oral treatment regimens for acute DVT or PE that can begin without an initial parenteral anticoagulation course.

Why are rifampin and carbamazepine concerning with apixaban or rivaroxaban?

Strong combined P-gp and CYP3A4 inducers, such as rifampin and carbamazepine, can reduce exposure and weaken anticoagulation; they should generally be avoided with apixaban or rivaroxaban.

What can certain drug inhibitors do to direct oral anticoagulant exposure?

Certain inhibitors can raise direct oral anticoagulant exposure and increase bleeding risk.

Should a direct oral anticoagulant dose be adjusted to reach a target INR?

No. INR guides warfarin therapy; it is not used to measure or adjust direct oral anticoagulant effect.

Do routine PT/INR or aPTT results reliably measure direct oral anticoagulant levels?

Routine PT/INR or aPTT results do not reliably quantify direct oral anticoagulant levels, and a normal result does not always rule out a clinically relevant level.

Which organ function is especially important to assess with dabigatran?

Clinicians should assess blood counts and kidney and liver function as appropriate. Impaired kidney clearance can increase drug exposure; dabigatran is particularly dependent on renal elimination.

Why should a patient avoid stopping a direct oral anticoagulant without medical advice?

Take it exactly as prescribed and do not stop without medical advice; stopping early can increase the risk of clots or stroke.