Practical Use of the Nonvitamin K Antagonist Oral Anticoagulants – MM1606
NOACs (nonvitamin K antagonist oral anticoagulants) are an alternative to vitamin K antagonists such as warfarin for: prevention of stroke in patients with nonvalvular atrial fibrillation and of venous thromboembolism in adults after elective total hip or knee replacement; treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) as well as prevention of recurrent DVT and PE.
The NOACs dabigatran and rivaroxaban differ in their properties, including mode of action and drug interactions; these differences must be taken into account when assessing patient suitability for NOAC therapy. Laboratory monitoring required for NOACs differs significantly from that used for warfarin. Perioperative use of NOACs is common but management differs between drugs, depending on their pharmacokinetic and pharmacodynamic properties.
Modern Medicine – June 2016
