A Review on Noval Anticoagulants

Abstract

The long term anticoagulation with warfarin is associated with various bleeding risks which led to the need for newer drugs. With the developments in the anticoagulation therapy the newer agents like dabigatran, rivaroxaba, apixaban and edoxaban have gained popularity with their more predictable pharmacological properties and reduced need for drug monitoring.The United States of America has approved both rivaroxaban and dabigatran to be used in the treatment of VTE (Venous Thrombo Embolism). In Europe and Canada dabigatran is prescribed after elective hip or knee arthroplasty to prevent VTE. For a VTE prophylaxis after an orthopediac surgery and to prevent stroke in AF patient, Rivaroxaban is recommended according to RECORD study. Edoxaban is highly effective in treatment of VTE and acts as a preventive measure of stroke in NVAF (Nonvalvular Atrial Fibrillation). Through this article various pharmacological aspects, dosing regimens, bleeding associated risk will be illustrated.

Raman study of nonhydrostatic pressure‐induced phase transitions in monoclinic L‐aspartic acid crystals

“…Murli suggests that the wavenumber of the torsional mode has a relationship with the distance of the shortest NH···O hydrogen bond and that the larger the wavenumber, the shorter the length is . We use the same method as that used for α‐glycine to infer that the length of the shortest NH···O distance in monoclinic L‐aspartic acid crystals is approximately 2.87 Å under atmospheric pressure and is obtained at a wavenumber of 466 cm ‐1 . This length is close to that of glutamic acid and longer than that of tyrosine, L‐alanine, valine, D‐ and L‐serine, α‐glycine, and L‐cysteine .…”

“…In a study of α‐glycine, scholars used the wavenumber of the NH 3 + torsional mode to infer the shortest NH···O distance of α‐glycine and to compare it with the distance in other amino acids . Murli suggests that the wavenumber of the torsional mode has a relationship with the distance of the shortest NH···O hydrogen bond and that the larger the wavenumber, the shorter the length is . We use the same method as that used for α‐glycine to infer that the length of the shortest NH···O distance in monoclinic L‐aspartic acid crystals is approximately 2.87 Å under atmospheric pressure and is obtained at a wavenumber of 466 cm ‐1 .…”

Pharmacologic Agents Used to Reverse the Anticoagulant Effect of Common Anticoagulants

“…Without adequate factor IIa activity, fibrinogen is not readily converted to fibrin so clot formation is reduced. These drugs bind directly to factor Xa to prevent thrombin formation and ensuing clot formation 29–31 …”

“…These drugs may prolong the PT/INR and aPTT; however, these tests are ineffective for monitoring the activity FXa inhibitors. Anti-FXa levels can be used to measure the anticoagulant effect, but this is not routinely done 29–31 …”

“…Other reported adverse effects include liver function abnormalities, nausea, and syncope. Andexanet alfa is the specific reversal agent for apixaban 30–33 …”