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Pharmacology Rounds – NOAC Overdose

Bryan Hayes, PharmD, DABAT and Anand Swaminathan, MD FAAEM
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08:22
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Nurses Edition Commentary

Kathy Garvin, RN and Lisa Chavez, RN
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01:17

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EMRAP 2018 07 July Vol.18 V2 Written Summary 390 KB - PDF

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Ian L., Dr -

I cannot understand why we do not use the Chromogenic Antifactor Xa for the Xa inhibitors and the dilute Thrombin time for Debigitran to help with estimating the number of tablets overdosed and the effect .
Described as reliable in Emergency Medical cases Episode88 by Anton Helman's EM nuggets team back in November 2016.
BeyerJ et al in Clinical Applications Thromb Hemost 2016 July 423-8 remarks a strong correlation of measured anti factor Xa and apixoban and rivaroxaban concentrations .
As the New Direct Oral AntiCoagulants are being now much more prescribed and the problem of Adherence and as yet determined drug interactions emerge these AntiFactor Xa and Dilute Thrombin levels ought be routinely available .

Bryan H. -

Thank you for your question. Most hospitals, at least in the U.S., do not have these laboratory tests readily available. And, in the institutions that can test for them, the turn around time for reporting results is often too long to be a useful clinical guide in emergency situations.

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EM:RAP 2018 July Full episode audio for MD edition 229:23 min - 319 MB - M4AEM:RAP 2018 July German Edition Deutsche 120:44 min - 166 MB - MP3EM:RAP 2018 July Spanish Edition Español 90:31 min - 124 MB - MP3EM:RAP 2018 July Australian Edition Australian 35:17 min - 48 MB - MP3EM:RAP 2018 July Canadian Edition Canadian 24:10 min - 33 MB - MP3EM:RAP 2018 July French Edition Français 27:05 min - 37 MB - MP3EM:RAP 2018 07 July Individual MP3 Files 293 MB - ZIPEMRAP 2018 07 July Individual Summaries 742 KB - ZIPEMRAP 2018 07 July Spanish Summary 1 MB - PDFEMRAP Board Review Answers 2018 07 July Vol.18 07 116 KB - PDFEMRAP 2018 07 July Vol.18 V2 Written Summary 390 KB - PDFEMRAP Board Review Questions 2018 07 July Vol.18 07 407 KB - PDF

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6 AMA PRA Category 1 Credits™ certified by CEME (EM:RAP)

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