This is a DOAC
Pharmacology
Pharmacodynamics:
Mechanism of action:
Direct Thrombin inhibitor
Pharmacokinetics:
Mainly cleared through renal clearance. therefore patient must have good renal function. this is checked before prescription and then annually
Indications:
Indicated for DVTs
PE prophylaxis and treatment
venous thromboembolism post arthroplasty
CAD and PAD
Contraindications:
Not great for valvular AF or mechanical valve thrombus formation
Risks and ADRS:
fewer adverse effects then warfarin, drug effect directly propertional to dose so we don’t need to take INR
Overdose:
Can be reversed with mAb - idarucizumab
Use
These drugs are used for patients with increased thrombotic risk:
- prolonged immobility (look at virchows triad)
- acute MI
- Coronary artery bypass artery (CABG)
- angioplasty