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Direct-Acting Oral Anticoagulants (DOACs) | MOA , Indications, Adverse Reactions, Contraindications
Official Ninja Nerd Website: https://ninjanerd.org
Ninja Nerds!
In this cardiovascular pharmacology lecture, Professor Zach Murphy delivers a high-yield breakdown of the Direct-Acting Oral Anticoagulants (DOACs), also known as NOACs (Novel Oral Anticoagulants)—a newer class of oral agents used as alternatives to warfarin for the prevention and treatment of thromboembolic disorders.
We begin by dividing the DOACs into two major categories based on their mechanism of action:
• Direct thrombin inhibitor: Dabigatran—inhibits factor IIa (thrombin)
• Direct factor Xa inhibitors: Rivaroxaban, Apixaban, Edoxaban, Betrixaban—selectively inhibit factor Xa
The lecture walks through pharmacokinetics, dosing considerations, and the predictable anticoagulant effects of DOACs that eliminate the need for routine lab monitoring in most patients. You’ll also learn about renal clearance, half-life, drug-drug interactions, and reversal strategies using agents like idarucizumab for dabigatran and andexanet alfa for factor Xa inhibitors.
We cover the major clinical uses of DOACs, including nonvalvular atrial fibrillation, deep vein thrombosis (DVT), pulmonary embolism (PE), and VTE prophylaxis, while also comparing their safety and bleeding profiles to warfarin.
Enjoy the lecture and support us below!
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