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Internal and Emergency Medicine
Published in: Internal and Emergency Medicine 3/2017

01-04-2017 | CE - ORIGINAL

Italian intersociety consensus on DOAC use in internal medicine

Authors: Domenico Prisco, Walter Ageno, Cecilia Becattini, Armando D’Angelo, Giovanni Davì, Raimondo De Cristofaro, Francesco Dentali, Giovanni Di Minno, Anna Falanga, Gualberto Gussoni, Luca Masotti, Gualtiero Palareti, Pasquale Pignatelli, Roberto M. Santi, Francesca Santilli, Mauro Silingardi, Antonella Tufano, Francesco Violi, SIMI (Italian Society of Internal Medicine), FADOI (Federation of Associations of Hospital Doctors on Internal Medicine), SISET (Italian Society for the Study of Haemostasis and Thrombosis)

Published in: Internal and Emergency Medicine | Issue 3/2017

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Abstract

The direct oral anticoagulants (DOACs) are drugs used in clinical practice since 2009 for the prevention of stroke or systemic embolism in non-valvular atrial fibrillation, and for the treatment and secondary prevention of venous thromboembolism. The four DOACs, including the three factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) and one direct thrombin inhibitor (dabigatran) provide oral anticoagulation therapy alternatives to Vitamin K antagonists (VKAs). Despite their clear advantages, the DOACs require on the part of the internist a thorough knowledge of their pharmacokinetic and pharmacodynamic characteristics to ensure their correct use, laboratory monitoring and the appropriate management of adverse events. This document represents a consensus paper on the use of DOACs by representatives of three Italian scientific societies: the Italian Society of Internal Medicine (SIMI), the Federation of the Associations of Hospital Managers (FADOI), and the Society for the Study of Haemostasis and Thrombosis (SISET). This document formulates expert opinion guidance for pragmatic managing, monitoring and reversing the anticoagulant effect of DOACs in both chronic and emergency settings. This practical guidance may help the internist to create adequate protocols for patients hospitalized ion internal medicine wards, where patients are often elderly subjects affected by poly-morbidities and renal insufficiency, and, thus, require particular attention to drug–drug interactions and peri-procedural protocols.
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Metadata
Title
Italian intersociety consensus on DOAC use in internal medicine
Authors
Domenico Prisco
Walter Ageno
Cecilia Becattini
Armando D’Angelo
Giovanni Davì
Raimondo De Cristofaro
Francesco Dentali
Giovanni Di Minno
Anna Falanga
Gualberto Gussoni
Luca Masotti
Gualtiero Palareti
Pasquale Pignatelli
Roberto M. Santi
Francesca Santilli
Mauro Silingardi
Antonella Tufano
Francesco Violi
SIMI (Italian Society of Internal Medicine)
FADOI (Federation of Associations of Hospital Doctors on Internal Medicine)
SISET (Italian Society for the Study of Haemostasis and Thrombosis)
Publication date
01-04-2017
Publisher
Springer International Publishing
Published in
Internal and Emergency Medicine / Issue 3/2017
Print ISSN: 1828-0447
Electronic ISSN: 1970-9366
DOI
https://doi.org/10.1007/s11739-017-1628-6

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