NOACs

Question 1

Name some NOACs

Answer 1

Rivaroxaban and Apixaban

Question 2

How do NOACs work?

Answer 2

Inhibit factor 10a so fibrinogen clot cannot be formed

Question 3

What are the common uses for NOACs?

Answer 3

1. VTE prophylaxis in hip and knee sugery
2. VTE treatment
3. VTE recurrence prophylaxis
4. Prevention of stoke and systemic embolism in those with non valvular AF

Question 4

What are the contraindications of using NOACs?

Answer 4

1. Active bleeding
2. Hepatic impairment (coagulopathies)
3. Renal impairment
4. Valvular heart disease
5. Unstable blood pressure
6. Active bleeding/stroke in those with ACS
7. Pregnancy

Question 5

What are some interactions of NOACs?

Answer 5

Aspirin
Apixaban
Diclofenac
Warfarin 
Clopidogrel
St Johns Wart (CYP3A4 inducer therefore will reduce levels of Rivaroxaban)

Question 6

What are the side effects of NOACs?

Answer 6

GI Upset
Dizziness 
Headache
Haemorrhage
Renal impairment
Pain in extremities
Rash
Pruitis

Question 7

How are NOACs excreted?

Answer 7

Metabolised by liver

Excreted in faeces and urine

Question 8

Why are NOACs used instead of warfarin?

Answer 8

No need to measure INR

However no antidote available in bleed