DTIs and DOACs

Q: All of the following are orally active direct factor Xa inhibitors except

A) rivaroxaban (Xarelto)

B) apixaban (Eliquis)

C) edoxaban (Lixiana, Savaysa)

D) betrixaban (Bevyxxa)

E) dabigatran (Pradaxa)

Answer: E

Dabigatran (Pradaxa) is the orally active Direct Thrombin Inhibitor (DTI); all others are orally active direct factor Xa inhibitors.

Reversal for Dabigatran is available. Also, it is dialysable. Dabigatran does not require frequent blood tests for INR monitoring. The half-life of Dabigatran is 12-17 hours. 

#pharmacology

#hematology

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. Ganetsky M, Babu KM, Salhanick SD, Brown RS, Boyer EW. Dabigatran: review of pharmacology and management of bleeding complications of this novel oral anticoagulant. J Med Toxicol. 2011 Dec;7(4):281-7. doi: 10.1007/s13181-011-0178-y. PMID: 21887485; PMCID: PMC3550194.

3. Comin J, Kallmes DF. Dabigatran (Pradaxa). AJNR Am J Neuroradiol. 2012 Mar;33(3):426-8. doi: 10.3174/ajnr.A3000. Epub 2012 Feb 16. PMID: 22345499; PMCID: PMC7966436.