Wie wirken orale Antikoagulantien?
NOAK (neue orale Antikoagulanzien), sind gerinnungshemmende und antithrombotische Wirkstoffe. Der gerinnungshemmende Effekt beruht auf der direkten Hemmung der Blutgerinnungsfaktoren. Sie stellen die Nachfolger der Heparine und Vitamin-K-Antagonisten zur Vorbeugung und Behandlung thromboembolischer Erkrankungen dar.
Was sind DOACs?
Neue direkte orale Antikoagulanzien (DOACs) umfassen direkte Thrombininhibitoren (1) und Faktor Xa-Antagonisten (2). DOACs werden zunehmend zur Langzeitantikoagulation bei Patienten mit nichtvalvulärem Vorhofflimmern oder venösen Thrombembolien eingesetzt (3).
When should warfarin and parenteral anticoagulation overlap?
A „bridge“ or „overlap“ of parenteral anticoagulation and warfarin therapy is necessary Early initiation of warfarin (ie. same day) is recommended Both are to be continued for a minimum of 5 days and until the INR is 2.0 or above for at least 24 hours.1
How do you switch from warfarin to dabigatran?
Switching between oral anticoagulants. Overlap warfarin with dabigatran for 3 days (normal renal function); 2 days (CrCl 30 to 50 mL/min); or 1 day (CrCl 15 to 30 mL/min); note that dabigatran can contribute to INR elevation. Overlap warfarin with dabigatran until the INR is therapeutic on warfarin (ASH).*.
Should I continue anticoagulation after switching from DOAC to warfarin?
Individuals switching from a DOAC to warfarin are more likely to require continuous anticoagulation if they have had a recent thromboembolic event or if they are at especially high risk of thromboembolism. Refer to UpToDate topics on specific indications, perioperative management, and the use of DOACs and warfarin for further details.
When do you stop warfarin and start rivaroxaban?
Stop warfarin, monitor the PT/INR, and start edoxaban when the INR is ≤2.5 (PI). Stop warfarin, monitor the PT/INR, and start rivaroxaban when the INR is <3 (PI). Start the second DOAC when the next dose of the first DOAC would have been due; do not overlap.