DOACs

 Q: Which of the following is not a direct oral anticoagulant (DOAC)? (select one) 

A) Rivaroxaban 

B) Apixaban 

C) Edoxaban 

D) Betrixaban

E) dronedarone

Answer; E

The objective of the above question is to highlight the mechanism of Direct Oral Anticoagulants. 

All of the DOACs end in "Xa-ban" - "Ban Factor Xa"!! They all directly bind directly to factor Xa. These drugs are direct factor Xa inhibitors and prevent factor Xa from cleaving prothrombin to thrombin.

They are different from warfarin as they are non-vitamin K antagonist oral anticoagulants. 

Dronedarone (Multaq) is a non-iodine based antiarrhythmic used in the treatment of atrial fibrillation or atrial flutter (choice E).

#pharmacology

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References:

1. Barnes GD, Ageno W, Ansell J, et al. Recommendation on the nomenclature for oral anticoagulants: communication from the SSC of the ISTH. J Thromb Haemost 2015; 13:1154. 

2. Schwarb H, Tsakiris DA. New Direct Oral Anticoagulants (DOAC) and Their Use Today. Dent J (Basel). 2016;4(1):5. Published 2016 Mar 11. doi:10.3390/dj4010005