title: Oral factor Xa and direct thrombin inhibitors: a clinical perspective.
abstract: Oral anticoagulation used to be synonymous with warfarin until the recent approval of oral direct thrombin inhibitors and factor Xa inhibitors in United States and other countries across the world. Thrombosis prevention and treatment continue to be the main objective and goal for surgical and medical patients. Regulatory agencies continue to revise their guidelines to treat these patients with appropriate medication and for optimal duration. As the choices for oral anticoagulants increase, with many oral anticoagulant drugs currently in the pipeline awaiting completion of clinical trials, the guidelines for venous thromboembolism prevention, stroke prevention in atrial fibrillation, and treatment of acute arterial and venous thrombi will also shift from the current standards to new standards set by these clinical trials for optimal dosing and duration of treatment. However, it must be reinforced that these new oral anticoagulants are distinct pharmacological compounds with specific targets and will also have distinct clinical indications for use.
authors.affiliation: Department of Medicine, Aurora Memorial Hospital, Burlington, Wisconsin 53105, USA.
authors.forename: Indermohan
authors.initials: I
authors.lastname: Thethi
authors.forename: Bruce
authors.initials: B
authors.lastname: Lewis
authors.forename: Jawed
authors.initials: J
authors.lastname: Fareed
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use; D000991:Antithrombins / Q000494:pharmacology / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects; D015951:Factor Xa / Q000627:therapeutic use; D065427:Factor Xa Inhibitors; D005260:Female; D006487:Hemostasis / Q000187:drug effects; D006801:Humans; D008297:Male; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D013923:Thromboembolism / Q000188:drug therapy / Q000517:prevention & control; D013927:Thrombosis / Q000188:drug therapy* / Q000517:prevention & control*; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D000991:Antithrombins; D065427:Factor Xa Inhibitors; D014859:Warfarin; D015951:Factor Xa