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BLOOD THINNERS

NOACs: Novel Oral Anti-Coagulants Comparison

In general, NOACs NOT recommended in any of the following circumstances:

  • Warfarin already working well for patient
  • Prosthetic heart valve
  • Renal insufficiency
  • Pregnancy
  • GI bleed risk is high
  • Poor compliance with medication

Coumadin reversal is covered elsewhere, but when PCC used, Profil-9 or Kcentra usually recommended.

SCROLL DOWN FOR REVERSAL TABLE FROM SAMPLE PAGE OF THE EMERGENCY MEDICINE 1-MINUTE CONSULT

Source: The Emergency Medicine 1-Minute Consult pocketbook

Abbreviations: Cr = creatinine, CrCl = creatinine clearance, ECT = ecarine clotting time, FFP = fresh frozen plasma, PT = prothrombin time, PTT = , TT = thrombin time, ULN = upper limit of normal, VTE = venous thromboembolism

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COAGULATION CASCADE:

The COAGULATION CASCADE iS extracted from the Emergency Medicine Pocketbook Series for free use.  All material is copyright.  However, you may reproduce any of our resources or ultrasound images for teaching purposes as long as you credit ERPocketbooks.com in print.  For commercial use, expressed written consent is required.

Please submit any comments or requests for additional topics below.

coagulation cascade

Comments

Comment from Dennis Goldfinger
Time: December 25, 2011, 10:24 pm

Comment from Dennis Goldfinger
Time: August 21, 2007, 9:56 am

Brady – This is excellent, although a little complicated with so much on one slide – We always use Roman numerals for coag factors, so that 5a & 8a should be corrected – I’m not sure what you mean when you say that the PTT reflects primarily Factor XI since it will detect significant deficiencies in any of the Factors that it includes – Anyway, very nice job – I’m proud of you – Dennis

Comment from Comment from Eric M Barach, M.D., FACEP
Time: December 25, 2011, 10:25 pm

Comment from Eric M Barach, M.D., FACEP
Time: October 22, 2007, 6:56 am

Need to make it just one step more complex and add Lovenox effect; probably on your lower left area, that is fairly empty, Mainly affecting factor X on a 4:1 basis over heparin, with minimal effects on thrombin and other factors.

Comment from ER Pocketbooks
Time: September 2, 2018, 12:55 am

FEIBA: Pradaxa, Xarelto, Eliquis
Profil 9 or Kcentra: Coumadin

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