Reversal of drug-induced anticoagulation: old solutions and new problems

被引:49
作者
Dzik, Walter 'Sunny' [1 ]
机构
[1] J224 Massachusetts Gen Hosp, Blood Transfus Serv, 55 Fruit St, Boston, MA 02114 USA
关键词
PROTHROMBIN COMPLEX CONCENTRATE; RECOMBINANT FACTOR VIIA; FRESH-FROZEN PLASMA; WARFARIN-ASSOCIATED COAGULOPATHY; INTERNATIONAL NORMALIZED RATIO; EMERGENCY REVERSAL; VITAMIN-K; DABIGATRAN; THROMBIN; THERAPY;
D O I
10.1111/j.1537-2995.2012.03690.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Anticoagulant drugs are taken by millions of patients throughout the world. Warfarin has been the most widely prescribed anticoagulant for decades. In recent years, new oral anticoagulants have been approved for use, are being positioned as alternatives to warfarin, and represent an enormous market opportunity for pharmaceutical companies. Requests for urgent reversal of anticoagulants are not uncommon especially in the setting of critical bleeding. This review summarizes information on reversal of warfarin by vitamin K, plasma, prothrombin complex concentrates, and recombinant VIIa. In addition, we emphasize the lack of current evidence supporting reversibility of the new oral direct thrombin inhibitors and Factor Xa inhibitors. This review is presented to assist transfusion medicine specialists, hematologists, and other clinicians who prescribe blood components for reversal of drug-induced anticoagulation.
引用
收藏
页码:45S / 55S
页数:11
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