Team what's happening zak here from med geeks were back so last week we reviewed different types of anti

coagulation so for this week I want to review what you do when it goes bad

aka what are the reversal agents?

So what do you need to know when you start thinking about the reversal agents?

Well, I run through four basic questions in my head.

One, is the patient actively bleeding,

aka do I have to take action immediately?

Two, what anticoagulant is the patient actually on?

Three, when was their last dose? And four, what does the patient

need the reversal for?

is it for a life-threatening bleed, an emergent surgical procedure?

So, last week we talked mainly about heparin products unfractionated and low molecular weight

warfarin xerelto eliquis and davagatran so I want to talk about the reversals for these. So let's start with

heparin, unfractionated or low molecular weight heparin. So the reversal agent is

protonine. It's solely used for heparin products. It binds to the heparin molecule, it

inactivates it into a salt, thereby it takes away the heparin's ability to increase

the effect of antithrombin 3. the and anti-10A is the marker you follow to look for a decrease after the

proamine has been given. Normally you repeat two hours after that initial

dose of protonine. All right let's move on to warfarin. So possible reversal agents include

vitamin K, fresh frozen plasma, four factor prothromic complex concentrates.

So vitamin K, also known as phytodion,

fresh frozen plasma, FFP,

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