PMID- 36827672
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230301
IS  - 2226-4787 (Electronic)
IS  - 2226-4787 (Linking)
VI  - 11
IP  - 1
DP  - 2023 Feb 11
TI  - Practical Guide for Anticoagulant and Antiplatelet Reversal in Clinical Practice.
LID - 10.3390/pharmacy11010034 [doi]
LID - 34
AB  - In recent years, anticoagulant and antiplatelet use have increased over the past 
      years for the prevention and treatment of several cardiovascular conditions. Due 
      to the rising use of antithrombotic medications and the complexity of specific 
      clinical cases requiring such therapies, bleeding remains the primary concern 
      among patients using antithrombotics. Direct oral anticoagulants (DOACs) include 
      rivaroxaban, apixaban, edoxaban, and betrixaban. Direct thrombin inhibitors 
      (DTIs) include argatroban, bivalirudin, and dabigatran. DOACs are associated with 
      lower rates of fatal, life-threatening, and significant bleeding risks compared 
      to those of warfarin. The immediate reversal of these agents can be indicated in 
      an emergency setting. Antithrombotic reversal recommendations are still in 
      development. Vitamin K and prothrombin complex concentrate (PCCs) can be used for 
      warfarin reversal. Andexanet alfa and idarucizumab are specific reversal agents 
      for DOACs and DTIs, respectively. Protamine sulfate is the solely approved 
      reversal agent for unfractionated heparin (UFH) and low-molecular-weight heparin 
      (LMWH). However, there are no specific reversal agents for antiplatelets. This 
      article aims to provide a practical guide for clinicians regarding the reversal 
      of anticoagulants and antiplatelets in clinical practice based on the most recent 
      studies.
FAU - Aldhaeefi, Mohammed
AU  - Aldhaeefi M
AD  - Department of Clinical and Administrative Pharmacy Sciences, Howard University 
      College of Pharmacy, Washington, DC 20059, USA.
FAU - Badreldin, Hisham A
AU  - Badreldin HA
AUID- ORCID: 0000-0001-7182-4347
AD  - Pharmaceutical Care Services, King Abdulaziz Medical Center, Riyadh 11426, Saudi 
      Arabia.
AD  - College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, 
      Riyadh 11426, Saudi Arabia.
AD  - King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia.
FAU - Alsuwayyid, Faisal
AU  - Alsuwayyid F
AUID- ORCID: 0000-0001-7969-1809
AD  - Department of Pharmaceutical Sciences, King Saud bin Abdulaziz University for 
      Health Sciences, Riyadh 11426, Saudi Arabia.
FAU - Alqahtani, Tariq
AU  - Alqahtani T
AD  - Department of Pharmaceutical Sciences, King Saud bin Abdulaziz University for 
      Health Sciences, Riyadh 11426, Saudi Arabia.
FAU - Alshaya, Omar
AU  - Alshaya O
AUID- ORCID: 0000-0002-2244-0491
AD  - Pharmaceutical Care Services, King Abdulaziz Medical Center, Riyadh 11426, Saudi 
      Arabia.
AD  - College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, 
      Riyadh 11426, Saudi Arabia.
AD  - King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia.
FAU - Al Yami, Majed S
AU  - Al Yami MS
AUID- ORCID: 0000-0003-2308-8407
AD  - Pharmaceutical Care Services, King Abdulaziz Medical Center, Riyadh 11426, Saudi 
      Arabia.
AD  - College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, 
      Riyadh 11426, Saudi Arabia.
AD  - King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia.
FAU - Bin Saleh, Khalid
AU  - Bin Saleh K
AD  - Pharmaceutical Care Services, King Abdulaziz Medical Center, Riyadh 11426, Saudi 
      Arabia.
AD  - College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, 
      Riyadh 11426, Saudi Arabia.
AD  - King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia.
FAU - Al Harbi, Shmeylan A
AU  - Al Harbi SA
AD  - Pharmaceutical Care Services, King Abdulaziz Medical Center, Riyadh 11426, Saudi 
      Arabia.
AD  - College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, 
      Riyadh 11426, Saudi Arabia.
AD  - King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia.
FAU - Alshaya, Abdulrahman I
AU  - Alshaya AI
AD  - Pharmaceutical Care Services, King Abdulaziz Medical Center, Riyadh 11426, Saudi 
      Arabia.
AD  - College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, 
      Riyadh 11426, Saudi Arabia.
AD  - King Abdullah International Medical Research Center, Riyadh 11426, Saudi Arabia.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230211
PL  - Switzerland
TA  - Pharmacy (Basel)
JT  - Pharmacy (Basel, Switzerland)
JID - 101678532
PMC - PMC9963371
OTO - NOTNLM
OT  - health improvement
OT  - health promotion
OT  - health protection
OT  - interventions
OT  - pharmacist
OT  - pharmacy technician
COIS- The authors declare no conflict of interest.
EDAT- 2023/02/25 06:00
MHDA- 2023/02/25 06:01
PMCR- 2023/02/11
CRDT- 2023/02/24 17:03
PHST- 2023/01/04 00:00 [received]
PHST- 2023/02/05 00:00 [revised]
PHST- 2023/02/09 00:00 [accepted]
PHST- 2023/02/24 17:03 [entrez]
PHST- 2023/02/25 06:00 [pubmed]
PHST- 2023/02/25 06:01 [medline]
PHST- 2023/02/11 00:00 [pmc-release]
AID - pharmacy11010034 [pii]
AID - pharmacy-11-00034 [pii]
AID - 10.3390/pharmacy11010034 [doi]
PST - epublish
SO  - Pharmacy (Basel). 2023 Feb 11;11(1):34. doi: 10.3390/pharmacy11010034.