Bloody Oral Anticoagulants – BCC talk 2014

The use of the New Oral Anticoagulant Drugs present unique challenges for the Intensive Care practitioner

1. The NOACs now have PBS approval for non-valvular AF, below knee DVT, DVT prophylaxis and low volume PE

2. There is no specific antidote for NOAC related bleeding but don’t despair there are some things that can help

3. Routine coagulation testing does not reflect drug levels or anticoagulation activity

Global sales of Dabigatran topped $1billion in 2012.

This talk outlines the pharmacodynamics and pharmacokinetics of the NOACs. Limitations and cautions of use are outlined with a review of the extensive literature. Clinical cases involving the NOACs are presented. The timing of stopping the agents before minor or major surgery, the approach to a patient with intracranial haemorrhage taking oral anticoagulants and the challenges faced when patients have an Acute Kidney Injury whilst taking these