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Coagulation

Coagulation laboratory tests

Dabigatran


Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 15 March 2012, last major update March 2012
Copyright: (c) 2002-2012, PathologyOutlines.com, Inc.

General
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● Oral anti-coagulant (also rivaroxaban, apixaban) with minimal food and drug interactions that does not require coagulation monitoring
● Drug is very expensive, and is affected by humidity (Wikipedia)
● Dabigatran etexilate is prodrug of dabigatran, a direct thrombin inhibitor
● Alternative to warfarin for reducing the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (J Clin Pharmacol 2012 Jan 31 [Epub ahead of print], J Med Econ 2012 Mar 7 [Epub ahead of print]) or venous thromboembolism (N Engl J Med 2009;361:2342, Vasc Health Risk Manag 2012;8:45)
● Good patient compliance (Orthop Traumatol Surg Res 2012 Mar 2 [Epub ahead of print])
● INR levels are not necessary, and are substantially higher using Hemochron Jr. point-of-care device compared with laboratory values (Am J Med 2012 Feb 3 [Epub ahead of print])
● Can use HEMOCLOT direct thrombin inhibitor assay to determine plasma concentrations of dabigatran (Blood Coagul Fibrinolysis 2012;23:138)
● Contraindications: nonvalvular atrial fibrillation patients with renal insufficiency (Rinsho Shinkeigaku 2011;51:1004), INR 2.0 or greater, age 80 years or greater (N Engl J Med 2012;366:864)

Drawings
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Structure and site of inhibition in coagulation cascade

End of Coagulation > Coagulation laboratory tests > Dabigatran


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