Limits...
Anticoagulation drug therapy: a review.

Harter K, Levine M, Henderson SO - West J Emerg Med (2015)

Bottom Line: Due to the narrow therapeutic index and need for frequent laboratory monitoring associated with warfarin, there has been a desire to develop newer, more effective anticoagulants.Consequently, the emergency physician should be familiar with the newer and older anticoagulants.This review emphasizes the indication, mechanism of action, adverse effects, and potential reversal strategies for various anticoagulants that the emergency physician will likely encounter.

View Article: PubMed Central - PubMed

Affiliation: University of Southern California, LA+USC Medical Center, Department of Emergency Medicine, Los Angeles, California.

ABSTRACT
Historically, most patients who required parenteral anticoagulation received heparin, whereas those patients requiring oral anticoagulation received warfarin. Due to the narrow therapeutic index and need for frequent laboratory monitoring associated with warfarin, there has been a desire to develop newer, more effective anticoagulants. Consequently, in recent years many novel anticoagulants have been developed. The emergency physician may institute anticoagulation therapy in the short term (e.g. heparin) for a patient being admitted, or may start a novel anticoagulation for a patient being discharged. Similarly, a patient on a novel anticoagulant may present to the emergency department due to a hemorrhagic complication. Consequently, the emergency physician should be familiar with the newer and older anticoagulants. This review emphasizes the indication, mechanism of action, adverse effects, and potential reversal strategies for various anticoagulants that the emergency physician will likely encounter.

Show MeSH
The coagulation cascade.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4307693&req=5

f1-wjem-16-11: The coagulation cascade.

Mentions: During routine homeostatic conditions, the human body maintains a constant balance between thrombus formation and destruction. This equilibrium is maintained by a complex interaction between platelets and the vascular endothelium, the coagulation cascade, and the fibrinolytic system. The coagulation cascade (Figure 1) involves an interaction between the contact activation pathway (previously called the intrinsic system), and the tissue factor pathway (previously the extrinsic system). These two seemingly independent pathways lead to the conversion of factor X to Xa, which is the start of the common pathway. This common pathway converts prothrombin to thrombin, which subsequently catalyzes the formation of fibrin and ultimately leads to the stabilization of aggregated platelets to form a stable clot.1,2


Anticoagulation drug therapy: a review.

Harter K, Levine M, Henderson SO - West J Emerg Med (2015)

The coagulation cascade.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4307693&req=5

f1-wjem-16-11: The coagulation cascade.
Mentions: During routine homeostatic conditions, the human body maintains a constant balance between thrombus formation and destruction. This equilibrium is maintained by a complex interaction between platelets and the vascular endothelium, the coagulation cascade, and the fibrinolytic system. The coagulation cascade (Figure 1) involves an interaction between the contact activation pathway (previously called the intrinsic system), and the tissue factor pathway (previously the extrinsic system). These two seemingly independent pathways lead to the conversion of factor X to Xa, which is the start of the common pathway. This common pathway converts prothrombin to thrombin, which subsequently catalyzes the formation of fibrin and ultimately leads to the stabilization of aggregated platelets to form a stable clot.1,2

Bottom Line: Due to the narrow therapeutic index and need for frequent laboratory monitoring associated with warfarin, there has been a desire to develop newer, more effective anticoagulants.Consequently, the emergency physician should be familiar with the newer and older anticoagulants.This review emphasizes the indication, mechanism of action, adverse effects, and potential reversal strategies for various anticoagulants that the emergency physician will likely encounter.

View Article: PubMed Central - PubMed

Affiliation: University of Southern California, LA+USC Medical Center, Department of Emergency Medicine, Los Angeles, California.

ABSTRACT
Historically, most patients who required parenteral anticoagulation received heparin, whereas those patients requiring oral anticoagulation received warfarin. Due to the narrow therapeutic index and need for frequent laboratory monitoring associated with warfarin, there has been a desire to develop newer, more effective anticoagulants. Consequently, in recent years many novel anticoagulants have been developed. The emergency physician may institute anticoagulation therapy in the short term (e.g. heparin) for a patient being admitted, or may start a novel anticoagulation for a patient being discharged. Similarly, a patient on a novel anticoagulant may present to the emergency department due to a hemorrhagic complication. Consequently, the emergency physician should be familiar with the newer and older anticoagulants. This review emphasizes the indication, mechanism of action, adverse effects, and potential reversal strategies for various anticoagulants that the emergency physician will likely encounter.

Show MeSH