![]() Warfarin, which inhibits vitamin K epoxide reductase, preventing the formation of vitamin K–dependent clotting factors (II, VII, IX, X), had previously been the only oral anticoagulant available. ![]() The widespread use of oral anticoagulants for various conditions has resulted in the necessity to have rapid-acting reversal agents in critical situations such as life-threatening bleeds or urgent surgical procedures. As a result, healthcare providers, principally pharmacists, must be prepared to appropriately monitor and manage patients requiring reversal. While no true antidote is yet available, several promising agents are in development. Unlike warfarin, limited options currently exist for rapid reversal of novel oral anticoagulants (direct thrombin inhibitors, factor Xa inhibitors) and include fresh frozen plasma and prothrombin complex concentrates. Coagulopathy is an inherent risk for all anticoagulants, and data regarding reversal of newer agents are sparse. ABSTRACT: Oral anticoagulants are commonly prescribed for the prevention and treatment of thromboembolic disorders.
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