DOAC Reversal Agents

Definition

DOAC Reversal Agents are medications used to counteract the effects of direct oral anticoagulants (DOACs) in cases of severe bleeding or emergency surgery. They work by neutralizing the anticoagulant activity to reduce the risk of hemorrhage.

5 Must Know Facts For Your Next Test

1. The primary DOAC reversal agents include idarucizumab for dabigatran and andexanet alfa for factor Xa inhibitors like rivaroxaban and apixaban.
2. Idarucizumab is a monoclonal antibody fragment that specifically binds to dabigatran, neutralizing its effect within minutes.
3. Andexanet alfa acts as a decoy receptor for factor Xa inhibitors, allowing normal clot formation to resume.
4. Activated charcoal can be used as an initial step if DOAC ingestion was recent, typically within two hours.
5. Monitoring parameters such as activated partial thromboplastin time (aPTT) and prothrombin time (PT) may not accurately reflect anticoagulation status with DOACs.

Review Questions

• What are the main DOAC reversal agents and which DOACs do they target?
• How does idarucizumab work to reverse the effects of dabigatran?
• Why might activated charcoal be used in managing a patient who has recently ingested a DOAC?

Related terms

Dabigatran: A direct thrombin inhibitor used as an anticoagulant.

Factor Xa Inhibitors: A class of anticoagulants that includes drugs like rivaroxaban and apixaban.

Activated Partial Thromboplastin Time (aPTT): A lab test measuring the efficacy of the intrinsic pathway of coagulation.