Management of new oral anticoagulants in gastrointestinal bleeding and endoscopy

• Published in: Gastroenterología y hepatología Vol. 38; no. 8; p. 501
• Main Authors: del Molino, Fátima, Gonzalez, Isabel, Saperas, Esteve
• Format: Journal Article
• Language: Spanish
• Published: Spain 01-10-2015
• Subjects: Administration, Oral; Antithrombins - administration & dosage; Antithrombins - adverse effects; Antithrombins - pharmacokinetics; Antithrombins - therapeutic use; Blood Coagulation Factors - therapeutic use; Blood Transfusion; Endoscopy, Digestive System - adverse effects; Factor Xa Inhibitors - administration & dosage; Factor Xa Inhibitors - adverse effects; Factor Xa Inhibitors - pharmacokinetics; Factor Xa Inhibitors - therapeutic use; Gastrointestinal Hemorrhage - chemically induced; Gastrointestinal Hemorrhage - drug therapy; Gastrointestinal Hemorrhage - etiology; Gastrointestinal Hemorrhage - therapy; Hemostatics - therapeutic use; Humans; Plasma Substitutes - therapeutic use; Practice Guidelines as Topic; Renal Dialysis; Thrombophilia - drug therapy; Hemorragia digestiva; Oral anticoagulation; Anticoagulantes orales directos; Gastrointestinal bleeding; Direct oral anticoagulants; Endoscopy; Endoscopia; Anticoagulación oral
• ISSN: 0210-5705
• DOI: 10.1016/j.gastrohep.2015.02.014

New oral direct anticoagulants agents are alternatives to warfarin for long-term anticoagulation in a growing number of patients that require long-term anticoagulation for atrial fibrillation, deep venous thrombosis and pulmonary embolism. These new agents with predictable pharmacokinetic and pharmacodynamics profiles offer a favorable global safety profile, but increased gastrointestinal bleeding compared to the vitamin K antagonists. Many gastroenterologists are unfamiliar and may be wary of these newer drugs, since Clinical experience is limited and no specific antidote is available to reverse their anticoagulant effect. In this article the risk of these new agents and, how to manage these agents in both the presence of acute gastrointestinal bleeding and in patients undergoing endoscopic procedures is reviewed.