Consensus document of the Sociedad Española de Patología Digestiva on massive nonvariceal gastrointestinal bleeding and direct-acting oral anticoagulants

Álvarez, F. Carballo; Albillos, Agustı́n; Llamas-Sillero, Pilar; Orive-Calzada, Aitor; Redondo–Cerezo, Eduardo; Santiago, Enrique Rodríguez de; Crespo, Javier

doi:10.17235/reed.2022.8920/2022

Cited by 3 publications

(1 citation statement)

References 159 publications

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“…Notably, if the bleeding is severe, activated charcoal, hemodialysis, hemoperfusion and the use of prothrombin complex concentrate may be considered. Activated charcoal can be administered to patients to lessen the intestinal absorption of residual medicine if the last dose of dabigatran is administered within 2 h [65]. However, this possible benefit needs to be evaluated against the damage that endoscopic visualization can subsequently cause.…”

Section: Severe Life-threatening Bleedingmentioning

confidence: 99%

A review on increasing risk for gastrointestinal bleeding associated with dabigatran

2024

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Dabigatran, a reversible direct thrombin inhibitor, is widely used in clinical practice as a therapeutic option due to its unique mechanism of action in comparison to other anticoagulants. Although patients taking dabigatran experience a reduced risk of fatal bleeding, a higher risk of gastrointestinal bleeding (GIB) is associated with dabigatran, and its rational use between anticoagulation and bleeding is challenging for clinicians. To prevent GIB, it is imperative for clinicians to understand the pharmacological characteristics of dabigatran to ensure that its prescription should be avoided in patients with bleeding. In this review, we summarize the mechanism of action and pharmacokinetics of dabigatran and bleeding sites in the gastrointestinal tract in patients treated with dabigatran, as well as discuss the factors that increase the risk of dabigatran-induced GIB, including dose, age, drug interactions, race, genetics and past medical history. Finally, the treatment and prevention of GIB with dabigatran is also discussed. This review will help clinicians choose their drugs and doses more carefully for treating GIB.

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Section: Severe Life-threatening Bleedingmentioning

confidence: 99%

A review on increasing risk for gastrointestinal bleeding associated with dabigatran

2024

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Assessing physicians’ knowledge, attitude, and practice on anticoagulant therapy in non-valvular atrial fibrillation: Syrian insights

Swed,

Bohsas,

Alibrahim

et al. 2024

Futur J Pharm Sci

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Background Atrial fibrillation (AF) is the most prevalent cardiac condition linked to increased mortality due to complications such as stroke. Oral anticoagulant (OAC) is the mainstay in preventing cerebrovascular accidents in patients with AF. Recent evidence identified gaps in physician’s knowledge in diagnosing and managing patients with AF. This study aims to assess Syrian physicians’ knowledge, attitude, and practices regarding the use of anticoagulant therapy in non-valvular AF (NVAF) patients. A cross-sectional study was conducted using a validated web-based questionnaire, which included 56 items separated into four sections that collected information about demographics, knowledge, attitude, and practices. Chi-square and Kruskal Wallis were performed to analyze the statistical relationships between the knowledge, attitude, practice, and demographic variables. Results A total of 497 participants completed the survey, of which 62.6% were between the ages of 25 and 35. The average participant scores for knowledge, attitude, and practices were (48.18 ± 21.57), (81.54 ± 9.26), and (62.83 ± 12.42), respectively. Participants who demonstrated good understanding, a positive attitude, and good practices were 22.3%, 87.3%, and 25.4%, respectively. The fear of bleeding was identified as the most significant barrier to initiating anticoagulant medication in AF patients (55.5%). Doctors who attended training had a better knowledge score than those who did not (mean ± S.D. = 57.24 ± 20.7). Participants who stated that over 70% of their AF patients use aspirin received the highest attitude score (mean ± S.D = 86.98 ± 21.17). PhD participants reported higher practice scores than those with other educational backgrounds (mean ± S.D = 73.96 ± 11.3). Conclusion This research showed that primary care physicians in Syria had optimistic views regarding OAC therapy, suggesting that training interventions targeting physicians may lead to improvement in the treatment of patients with NVAF in Syria.

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Hemorragia digestiva alta

Redondo Sánchez

2024

AMF

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La HDA es un proceso clínico relativamente frecuente y que se define por cualquier hemorragia que tenga su origen por encima del ligamento de Treitz. Este artículo revisa su presentación, las causas y factores de riesgo, la estratificación del riesgo, el tratamiento y prevención, con especial énfasis en el manejo de la medicación antiagregante y anticoagulante en este grupo de pacientes. Se centra en los casos de HDA de carácter no varicoso, dado que las hemorragias procedentes de sangrado de varices esofágicas requieren otros planteamientos.

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Consensus document of the Sociedad Española de Patología Digestiva on massive nonvariceal gastrointestinal bleeding and direct-acting oral anticoagulants

Cited by 3 publications

References 159 publications

A review on increasing risk for gastrointestinal bleeding associated with dabigatran

A review on increasing risk for gastrointestinal bleeding associated with dabigatran

Assessing physicians’ knowledge, attitude, and practice on anticoagulant therapy in non-valvular atrial fibrillation: Syrian insights

Hemorragia digestiva alta

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