Measuring or Monitoring of Novel Anticoagulants: Which Laboratory Test to Request?

• Published in: Current emergency and hospital medicine reports Vol. 1; no. 4; pp. 208 - 216
• Main Authors: Dobesh, Paul P., Terry, Kimberly J.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01-12-2013; Springer Nature B.V
• Subjects: Anticoagulants; Bioavailability; Bone surgery; Cardiac arrhythmia; Chromatography; Cytochrome; Drug dosages; Emergency Medicine; FDA approval; Glycoproteins; Laboratories; Medicine; Medicine & Public Health; Metabolism; Orthopedics; Patients; Pharmacodynamics; Pharmacokinetics; Pharmacology of Acute Care (J Fanikos; Plasma; Prevention; Section Editor; Stroke; Thromboembolism; United States > US; Direct thrombin inhibitors; Anticoagulants; Rivaroxaban; Blood coagulation tests; Dabigatran; Apixaban
• ISSN: 2167-4884; 2167-4884
• DOI: 10.1007/s40138-013-0029-z

Oral anticoagulants are now available with predictable pharmacokinetic and pharmacodynamic profiles, therefore eliminating the need for routine therapeutic monitoring. There are a number of clinical scenarios in which the ability to measure the pharmacodynamic and pharmacologic activity of these agent would be desirable. Since these new oral anticoagulants do not impact traditional coagulation assays like warfarin or heparins, and impact the assays differently among agents, measuring and monitoring creates a challenge for clinicians who care for these patients in the emergency or hospitalized setting. Understanding the effect of these agents, the available assays, and the interpretation of results is an element of their safe and effective use.