Do You Know Your NOACs? Let’s Review the Novel Oral Anticoagulants

When it comes to oral anticoagulants, warfarin is no longer the only game in town. The past decade has brought new oral anticoagulant therapy with novel mechanisms of action. Whether practicing in a health system or community setting, understanding the uses, new mechanisms of action, and differences between these new agents is crucial to exceptional patient care. This activity will review the four novel oral anticoagulants (NOACs): apixaban, dabigatran, edoxaban, and rivaroxaban, and will discuss their mechanism of action, indications, dosing, adverse effects and drug interactions. The activity will include a review of the anticoagulation cascade with a focus on the place of each drug in the cascade and how they differ from warfarin. Other discussions will include the role of NOACs in the treatment of atrial fibrillation and prevention of deep vein thrombosis and pulmonary embolism based on current CHEST guidelines as well as those developed by the American College of Cardiology, American Heart Association, and European Society of Cardiology. Lastly, the activity will present various counseling points, precautions, and boxed warnings pertinent to patient care.