New Oral Anticoagulants
Continuing Education Credits
This course addresses some of the new oral anticoagulants that are being used and some of the challenges faced when using traditional coagulation tests to assess the drug effects. Strategies for effectively monitoring these new therapeutic drugs, along with the advantages and disadvantages of their use, are discussed.
Objectives
- Review the principles of the normal blood coagulation clotting cascade.
- Compare the characteristics and associated mode of actions of the four FDA-approved new oral anticoagulants (NOACs).
- Name the FDA approved clinical applications of various anticoagulant therapies.
- Describe the NOACs specimen processing, storage, and shipping requirements.
- Compare first-line common and NOAC-specific laboratory coagulation assessment procedures.
- Summarize the clinical interpretations of coagulation testing results including potential interference factors.
- Describe the two approved bleeding reversal agents mode of action.
Course Outline
- Coagulation Overview
- Coagulation Cascade Overview
- Pathways for Coagulation
- Pathways
- Extrinsic Pathway
- Intrinsic Pathway
- Common Pathway
- Fibrin Clot and Fibrinolysis
- The intrinsic pathway for coagulation begins with the activation of which of the following factors?
- The final common pathway begins with the activation of which of the following factors?
- Case Study #1
- Traditional and New Oral Blood Anticoagulants
- Traditional and New Oral Anticoagulants
- Traditional Blood Anticoagulants
- Traditional Anticoagulants
- Heparin inhibits the clotting of blood by neutralizing the effect of which of the following?
- Warfarin is an antagonist of which of the following vitamins?
- New Oral Anticoagulants
- New Oral Anticoagulants
- New Oral Anticoagulants, continued
- Thrombin Inhibitor
- Factor Xa Inhibitors
- Which of the NOACs impacts thrombin?
- Clinical Applications of Novel Oral Anticoagulants
- Clinical Applications of Novel Oral Anticoagulants
- Laboratory Assessment
- Reason to Test
- Case Study #2
- The Gold Standard Assay
- The Gold Standard Assay
- "Front Line" Common Coagulation Tests
- Front Line Common Coagulation Tests
- Specific NOAC Testing Methods
- Specific NOAC Testing Methods
- Specific NOAC Testing Methods, continued
- The PT can detect deficiencies of the following factors except:
- Impact of NOACs on Other Coagulation Assays of Importance
- Impact of NOACs on Other Coagulation Assays
- NOAC Impact on Antithrombin Activity and Activated Protein C Resistance
- NOAC Impact on Coagulation Factors and Fibrinogen
- NOAC Impact on Lupus Anticoagulants and Protein C/Protein S Activity
- Specimen Collection and Processing
- Specimen Collection and Processing
- A blood specimen from a patient receiving anti-Xa therapy can be stored for a maximum of how many hours after collection?
- After collection, a plasma specimen from a patient receiving NOAC therapy can be stored in a freezer for a maximum of how long?
- Interpretation of Test Results
- Clinical Interpretations of Prothrombin and Activated Partial Thromboplastin Time
- Prothrombin Time
- Prothrombin Time
- Activated Partial Thromboplastin Time
- Activated Partial Thromboplastin Time
- Comparative Clinical Interpretation of Coagulation Results
- Interpretation of Coagulation Assay Results
- Interference with Results
- Anticoagulation Reversal Agents
- Anticoagulation Reversal Agents
- Which of the following reversal anticoagulant therapies is appropriate for patients being treated with dabigatran who experience massive bleeding?
- Conclusion
- Conclusion
- References
- References
Additional Information
Level of Instruction: Intermediate
Intended Audience: Medical laboratory scientists, medical laboratory technicians, laboratory supervisors, and laboratory managers. This course is also appropriate for MLS and MLT students and pathology residents.
Author Information: Mary Louise Turgeon, Ed.D, MLS(ASCP)CM, is the author of four medical laboratory science textbooks: Basic & Applied Clinical Laboratory Science (8th ed.), Elsevier (2020); Immunology and Serology in Laboratory Medicine (7th ed.), Elsevier (2022); Clinical Hematology (6th ed.), Lippincott-Williams & Wilkins (2018); and Fundamentals of Immunohematology (2nd ed.). Foreign language editions have been published in Chinese, Spanish, and Italian. Dr. Turgeon has 18 years of university and 15 years of community college teaching and program administration experience. Guest speaking, scientific presentations, and technical and educational workshops complement her teaching and writing activities.
Reviewer Information: Laurie Bjerklie, MA, MLS(ASCP)CM, is
an Education Developer for MediaLab and LabCE. She earned a B.S. in Medical
Laboratory Science from the University of North Dakota and an M.A. in
Curriculum and Instruction from Saint Xavier University. She has over 15 years
of experience in higher education and has held program director and faculty
positions in both MLT and MLS programs.
Course Description: This course addresses the new oral anticoagulants being used and some of the challenges faced when using traditional coagulation tests to assess drug effects. Strategies for effectively monitoring these new therapeutic drugs, along with the advantages and disadvantages of their use, are discussed.