title: [Management of new oral anticoagulants in gastrointestinal bleeding and endoscopy].
abstract: New oral direct anticoagulants agents are alternatives to warfarin for long-term anticoagulation in a growing number of patients that require long-term anticoagulation for atrial fibrillation, deep venous thrombosis and pulmonary embolism. These new agents with predictable pharmacokinetic and pharmacodynamics profiles offer a favorable global safety profile, but increased gastrointestinal bleeding compared to the vitamin K antagonists. Many gastroenterologists are unfamiliar and may be wary of these newer drugs, since Clinical experience is limited and no specific antidote is available to reverse their anticoagulant effect. In this article the risk of these new agents and, how to manage these agents in both the presence of acute gastrointestinal bleeding and in patients undergoing endoscopic procedures is reviewed.
authors.affiliation: Servicio de Médicina Interna, IDC Clínica del Vallés, Sabadell, Barcelona, España; Comité de Enfermedad Tromboembólica y Anticoagulación de IDC Hospitales de Cataluña.
authors.forename: Fátima
authors.initials: F
authors.lastname: del Molino
authors.affiliation: Comité de Enfermedad Tromboembólica y Anticoagulación de IDC Hospitales de Cataluña; Servicio de Hematología y Hemoterapia BST, Hospital Mútua de Terrassa, Tarrasa, España.
authors.forename: Isabel
authors.initials: I
authors.lastname: Gonzalez
authors.affiliation: Comité de Enfermedad Tromboembólica y Anticoagulación de IDC Hospitales de Cataluña; Servicio de Aparato Digestivo y Endoscopia, IDC Hospital General de Catalunya, Universidad Internacional de Catalunya, San Cugat del Vallés, Barcelona, España. Electronic address: esteban.saperas@idcsalud.es.
authors.forename: Esteve
authors.initials: E
authors.lastname: Saperas
mesh_terms: D000284:Administration, Oral; D000991:Antithrombins / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D001803:Blood Transfusion; D016145:Endoscopy, Digestive System / Q000009:adverse effects; D065427:Factor Xa Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000188:drug therapy / Q000209:etiology / Q000628:therapy; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D010952:Plasma Substitutes / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D006435:Renal Dialysis; D019851:Thrombophilia / Q000188:drug therapy
chemical_list: D000991:Antithrombins; D001779:Blood Coagulation Factors; D065427:Factor Xa Inhibitors; D006490:Hemostatics; D010952:Plasma Substitutes; C025667:prothrombin complex concentrates
keywords: Anticoagulación oral; Anticoagulantes orales directos; Direct oral anticoagulants; Endoscopia; Endoscopy; Gastrointestinal bleeding; Hemorragia digestiva; Oral anticoagulation