Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-26T06:08:33.306Z Has data issue: false hasContentIssue false
  • English
  • Français

New oral anticoagulants – a guide for ENT surgeons

Published online by Cambridge University Press:  02 February 2016

S Kumar  and
R Moorthy
S Kumar*
Affiliation:
ENT Department, John Radcliffe Hospital, Oxford, UK
R Moorthy
Affiliation:
ENT Department, Wexham Park Hospital, Slough, UK
*
Address for correspondence: Ms Sonia Kumar, ENT Department, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

New oral anticoagulants have been developed to overcome the perceived disadvantages of more traditional anticoagulants such as heparin and warfarin, and their use amongst ENT patients have been increasing.

Objectives:

This review article aims to discuss the mechanism of action of new oral anticoagulants, when they should be used and a protocol for their use, in both the bleeding patient and in the peri-operative setting.

Conclusion:

It is important that ENT surgeons are aware of the use of new oral anticoagulants, and have a departmental- and trust-based policy on their use and reversal in bleeding and surgical patients.

Keywords

HemorrhageFactor Xa InhibitorsAntithrombins
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 4 , April 2016 , pp. 324 - 328
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Shehab, N, Sperling, L, Kegler, S, Budnitz, D. National estimates of emergency department visits for hemorrhage-related adverse events from clopidogrel plus aspirin and from warfarin. Arch Intern Med 2010;170:1926–33CrossRefGoogle ScholarPubMed
2Smith, J, Siddiq, S, Dyer, C, Rainsbury, J, Kim, D. Epistaxis in patients taking oral anticoagulant and antiplatelet medication: prospective cohort study. J Laryngol Otol 2011;125:38–42CrossRefGoogle ScholarPubMed
3Hollowell, J, Ruigómez, A, Johansson, S, Wallander, M, García-Rodríguez, L. The incidence of bleeding complications associated with warfarin treatment in general practice in the United Kingdom. Brit J Gen Pract 2003;53:312–14Google ScholarPubMed
4Stafford, R, Singer, D. National patterns of warfarin use in atrial fibrillation. Arch Intern Med 1996;156:2537–41Google Scholar
5Cohen, A, Imfeld, S, Rider, T. Phase III trials of new oral anticoagulants in the acute treatment and secondary prevention of VTE: comparison and critique of study methodology and results. Adv Ther 2014;31:473–93Google Scholar
6National Institute for Health and Care Excellence. Apixaban for the prevention of stroke and systemic embolism in people with nonvalvular atrial fibrillation. In: http://www.nice.org.uk/ta275 [6 January 2015]Google Scholar
7National Institute for Health and Care Excellence. Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults. In: http://www.nice.org.uk/ta170 [6 January 2015]Google Scholar
8National Institute for Health and Care Excellence. Rivaroxaban for the prevention of stroke and systemic embolism in atrial fibrillation. In: http://www.nice.org.uk/ta256 [6 January 2015]Google Scholar
9National Institute for Health and Care Excellence. Rivaroxaban for the treatment of deep vein thrombosis and prevention of recurrent deep vein thrombosis and pulmonary embolism. In: http://www.nice.org.uk/ta261 [6 January 2015]Google Scholar
10National Institute for Health and Care Excellence. Dabigatran etexilate for the prevention of venous thromboembolism after hip or knee replacement surgery in adults. In: http://www.nice.org.uk/ta157 [6 January 2015]Google Scholar
11National Institute for Health and Care Excellence. Dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation. In: http://www.nice.org.uk/ta249 [6 January 2015]Google Scholar
12Scaglione, F. New oral anticoagulants: comparative pharmacology with vitamin K antagonists. Clin Pharmacokinet 2013;52:69–82CrossRefGoogle ScholarPubMed
13Poulsen, B, Grove, E, Husted, S. New oral anticoagulants: a review of the literature with particular emphasis on patients with impaired renal function. Drugs 2012;72:1739–53Google Scholar
14The new oral anticoagulants Eliquis®, Pradaxa®, Xarelto®. Beware of the risk factors for bleeding, pay attention to posology, contraindications, and warnings and precautions for use to reduce the risk of bleeding In: http://webarchive.nationalarchives.gov.uk/20141205150130/http://www.mhra.gov.uk/home/groups/pl-p/documents/drugsafetymessage/con321961.pdf [6 January 2015]Google Scholar
15Heidbuchel, H, Verhamme, P, Alings, M, Antz, M, Hacke, W, Oldgren, J et al. EHRA practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary. Eur Heart J 2013;34:2094–106Google Scholar