Abstract
The past decade has witnessed an explosion in the clinical development of new orally-administered anticoagulant drugs aimed at complementing vitamin K antagonists and heparins for the prevention and treatment of venous thromboembolism, for the prevention of stroke in patients with chronic atrial fibrillation, and for treatment of acute coronary syndromes. This review will focus on those new oral anticoagulants that are most relevant to the practicing clinician. These drugs consist of dabigatran, a direct thrombin inhibitor and rivaroxaban, a factor Xa inhibitor, both of which have been recently approved for clinical use. In addition, apixaban will be reviewed, which is another factor Xa inhibitor that is in the final stages of clinical development. The objectives of this review are: 1) to provide a clinician-oriented overview of the key pharmacokinetic and pharmacodynamic properties of dabigatran, rivaroxaban and apixaban; and 2) to consider the implications of these drugs pharmacologic properties in the perioperative setting for patients who require elective or urgent surgery, focusing on pre- and post-operative dosing, laboratory monitoring and reversal of anticoagulant effect.
Keywords: New anticoagulants, perioperative anticoagulation, pharmacokinetics, pharmacodynamics, Anticoagulants, vitamin K, heparins, thromboembolism, chronic atrial fibrillation, acute coronary syndromes, dabigatran, thrombin inhibitor, ri-varoxaban, Xa inhibitor, rivaroxaban, dabigatran etexilate, TAK 442, eribaxaban LY517717, DU 176b, YM 150, acenocoumarol, phenprocoumon, warfarin, fondaparinux, hirudin, lepirudin, argatroban, tartaric acid, cytochrome P-450, acylglucoronidases, creatinine, prothrombin, fibrinogen, ecarin clotting time, P-glycoprotein, CYP pathway, hepatic biliary excretion, anti-arrhythmic, verapamil, CYP-independent mechanisms, ketoconazle, vori-conazole, fluconazole, spinal/epidural anesthesia, bridging anticoagulation
Current Pharmaceutical Design
Title: Pharmacologic Properties of the New Oral Anticoagulants: A Clinician-oriented Review with a Focus on Perioperative Management
Volume: 16 Issue: 31
Author(s): James D. Douketis
Affiliation:
Keywords: New anticoagulants, perioperative anticoagulation, pharmacokinetics, pharmacodynamics, Anticoagulants, vitamin K, heparins, thromboembolism, chronic atrial fibrillation, acute coronary syndromes, dabigatran, thrombin inhibitor, ri-varoxaban, Xa inhibitor, rivaroxaban, dabigatran etexilate, TAK 442, eribaxaban LY517717, DU 176b, YM 150, acenocoumarol, phenprocoumon, warfarin, fondaparinux, hirudin, lepirudin, argatroban, tartaric acid, cytochrome P-450, acylglucoronidases, creatinine, prothrombin, fibrinogen, ecarin clotting time, P-glycoprotein, CYP pathway, hepatic biliary excretion, anti-arrhythmic, verapamil, CYP-independent mechanisms, ketoconazle, vori-conazole, fluconazole, spinal/epidural anesthesia, bridging anticoagulation
Abstract: The past decade has witnessed an explosion in the clinical development of new orally-administered anticoagulant drugs aimed at complementing vitamin K antagonists and heparins for the prevention and treatment of venous thromboembolism, for the prevention of stroke in patients with chronic atrial fibrillation, and for treatment of acute coronary syndromes. This review will focus on those new oral anticoagulants that are most relevant to the practicing clinician. These drugs consist of dabigatran, a direct thrombin inhibitor and rivaroxaban, a factor Xa inhibitor, both of which have been recently approved for clinical use. In addition, apixaban will be reviewed, which is another factor Xa inhibitor that is in the final stages of clinical development. The objectives of this review are: 1) to provide a clinician-oriented overview of the key pharmacokinetic and pharmacodynamic properties of dabigatran, rivaroxaban and apixaban; and 2) to consider the implications of these drugs pharmacologic properties in the perioperative setting for patients who require elective or urgent surgery, focusing on pre- and post-operative dosing, laboratory monitoring and reversal of anticoagulant effect.
Export Options
About this article
Cite this article as:
D. Douketis James, Pharmacologic Properties of the New Oral Anticoagulants: A Clinician-oriented Review with a Focus on Perioperative Management, Current Pharmaceutical Design 2010; 16 (31) . https://dx.doi.org/10.2174/138161210793563338
DOI https://dx.doi.org/10.2174/138161210793563338 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Vitamin D: Evolutionary, Physiological and Health Perspectives
Current Drug Targets Recent Patents on Biomedical Applications for the Treatment of Atherosclerosis
Recent Patents on Regenerative Medicine Nanocarriers Loaded with Oxygen to Improve the Protection of the Heart to be Transplanted
Current Pharmaceutical Design Proteins in Pharmacology: Restrictions, Challenges and Opportunities
Current Medicinal Chemistry Pharmacotherapy Before and After Endovascular Repair of Abdominal Aortic Aneurysms
Current Vascular Pharmacology Intrauterine Growth Restriction in Singleton Pregnancy-Surveillance and Delivery: An Overview
Current Women`s Health Reviews Pharmacology of the Human Saphenous Vein
Current Vascular Pharmacology Telomeres and their Role in Aging and Longevity
Current Vascular Pharmacology Sepsis Pathophysiology and Anesthetic Consideration
Cardiovascular & Hematological Disorders-Drug Targets Dendritic Cell-Based Immune Therapy in Liver Diseases
Current Immunology Reviews (Discontinued) Perinatal Heart Programming: Long-term Consequences
Current Medicinal Chemistry Recent Advances and Novel Approaches for Nose to Brain Drug Delivery for Treatment of Migraine
Drug Delivery Letters Complications of Diabetes: An Insight into Genetic Polymorphism and Role of Insulin
Recent Patents on Inflammation & Allergy Drug Discovery Amplified Crosstalk Between Estrogen Binding and GFR Signaling Mediated Pathways of ER Activation Drives Responses in Tumors Treated with Endocrine Disruptors
Recent Patents on Anti-Cancer Drug Discovery Menopausal Hormone Therapy and Cardiovascular Risk: Where are we Now?
Current Vascular Pharmacology Depressed Glucose Consumption at Reperfusion following Brain Ischemia does not Correlate with Mitochondrial Dysfunction and Development of Infarction: An in vivo Positron Emission Tomography Study
Current Neurovascular Research Molecular Mechanisms of Skeletal Muscle Insulin Resistance in Type 2 Diabetes
Current Diabetes Reviews Melanocortins As Innovative Drugs for Ischemic Diseases and Neurodegenerative Disorders: Established Data and Perspectives
Current Medicinal Chemistry Neurobehavioral Effects of β-Escin
Current Psychopharmacology Systemic Delivery of siRNA: Challenging but Promising
Recent Patents on Drug Delivery & Formulation