Department of Medicine, Hennepin Healthcare; Assistant Professor of Medicine, University of Minnesota Medical School, Minneapolis, MN
Department of Pharmacy, Hennepin Healthcare, Minneapolis, MN; Clinical Associate Professor, College of Pharmacy, University of Minnesota, Minneapolis, MN.
Cleve Clin J Med. 2021 Feb 1;88(2):98-103. doi: 10.3949/ccjm.88a.19133.
The 2019 guideline from the Anticoagulation Forum provides clear instructions on how to use 2 agents for reversing the effects of direct oral anticoagulants (DOACs): idarucizumab for dabigatran-associated bleeding and andexanet alfa for bleeding associated with rivaroxaban and apixaban. The guideline also discusses off-label use of andexanet alfa for bleeding associated with edoxaban and betrixaban and the use of hemostatic agents such as activated prothrombin complex concentrate and 4-factor prothrombin complex concentrate. Lastly, it offers approaches for building and managing stewardship programs at the health system level.
抗凝论坛 2019 年指南就如何使用 2 种药物逆转直接口服抗凝剂（DOAC）的作用提供了明确的指导：idarucizumab 用于达比加群相关出血，andexanet alfa 用于利伐沙班和阿哌沙班相关出血。该指南还讨论了 andexanet alfa 用于依度沙班和贝曲沙班相关出血的超适应证使用，以及使用止血剂如活化的凝血酶原复合物浓缩物和 4 因子凝血酶原复合物浓缩物。最后，它还提供了在卫生系统层面建立和管理管理计划的方法。
