New Anticoagulants for the Prevention of Thromboembolism

Kylie      Lepic; Mark      Crowther

Abstract

The traditional agents used for thromboprophylaxis are effective and safe but have limitations particularly related to ease of administration. Newer agents targeting single coagulation factors such as the direct thrombin inhibitor dabigatran and the factor Xa inhibitors rivaroxaban and apixaban have demonstrated efficacy and safety for thromboembolism prophylaxis in the orthopedic population and have the additional benefit of oral administration and predictable pharmacokinetics. Pharmacology of the new anticoagulants and published data on the use of these agents in total knee and hip replacement patients will be reviewed in this article.

Keywords: Thromboprophylaxis, dabigatran, rivaroxaban, apixaban, Anticoagulants, Thromboembolism, Venous thromboembolism, low molecular, synthetic pentasaccharide, vitamin K antagonists, warfarin, narrow therapeutic index, multiple drug, DABIGATRAN ETEXILATE, quinine, verapamil, total hip replacement, total knee replacement, RE-NOVATE, creatinine, enoxaparin, nonfatal PE, proximal DVT, factor Xa, VTE prophylaxis, thrombin inhibitor, hip arthroplasty, pharmacokinetics, knee replacement