DOAC A

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DOAC A (Direct Oral Anticoagulant Apixaban) is an anticoagulant medication used to prevent blood clots and reduce stroke risk.

What does DOAC A mean?

What is ?

DOAC A refers to Apixaban, a type of Direct Oral Anticoagulant used in UK primary care. It works by inhibiting Factor Xa in the coagulation pathway, preventing blood clot formation. Apixaban (commonly prescribed as Eliquis) is frequently used to prevent stroke in patients with non-valvular atrial fibrillation, treat deep vein thrombosis (DVT), pulmonary embolism (PE), and prevent recurrent DVT and PE. It's a common alternative to warfarin as it requires less monitoring and has fewer food and drug interactions.

DOAC A Best Practices

What is ?

  • Always assess bleeding risk before prescribing DOAC A using validated tools such as HAS-BLED
  • Monitor renal function regularly as dosage adjustments may be needed for patients with impaired kidney function
  • Provide patients with clear information about potential side effects, especially signs of bleeding
  • Consider medication interactions, particularly with other anticoagulants, antiplatelets or NSAIDs
  • Ensure appropriate transition protocols when switching between anticoagulants

Use DOAC A in a Sentence

What is ?

  1. The GP prescribed DOAC A for her atrial fibrillation to reduce the risk of stroke.
  2. When monitoring patients on DOAC A, healthcare professionals should be vigilant for signs of unusual bleeding.
  3. Unlike warfarin, DOAC A does not require regular INR monitoring, making it more convenient for many patients.
Frequently Asked Questions about
DOAC A

What does DOAC A mean?

DOAC A stands for Direct Oral Anticoagulant Apixaban. It is an oral medication used to prevent blood clots by inhibiting Factor Xa in the coagulation pathway. Apixaban (brand name Eliquis) is commonly prescribed in UK primary care settings to prevent stroke in patients with atrial fibrillation and to treat or prevent deep vein thrombosis and pulmonary embolism.

How does DOAC A differ from traditional anticoagulants like warfarin?

DOAC A (Apixaban) offers several advantages over traditional anticoagulants like warfarin. It has a more predictable effect, eliminating the need for regular INR monitoring. It has fewer food interactions, a fixed dosing regimen, and faster onset and offset of action. DOAC A also has a lower risk of intracranial bleeding compared to warfarin, though the risk of gastrointestinal bleeding may be similar or slightly higher. These benefits make DOAC A easier to manage in primary care settings.

What are the main side effects and risks of DOAC A?

The main side effect of DOAC A (Apixaban) is bleeding, which can range from minor bruising to severe haemorrhage. Patients may experience nosebleeds, bruising, blood in urine or stools, or unusually heavy menstrual bleeding. Other potential side effects include anaemia, nausea, and skin rash. Unlike warfarin, there is no specific antidote widely available in all settings, though andexanet alfa can be used to reverse the effects in emergency situations. Regular monitoring for signs of bleeding is essential for patient safety.

When should DOAC A be prescribed in primary care?

DOAC A (Apixaban) is typically prescribed in primary care for patients with non-valvular atrial fibrillation to reduce stroke risk, for treating deep vein thrombosis (DVT) and pulmonary embolism (PE), and for preventing recurrent DVT and PE. It may be preferred for patients who have difficulties maintaining a stable INR on warfarin, those with contraindications to warfarin, or patients who prefer not to have regular blood tests. The decision should be based on individual patient factors including age, weight, renal function, and bleeding risk.

How should medication adherence with DOAC A be managed in a Primary Care Network?

Managing medication adherence with DOAC A in a Primary Care Network involves a multi-faceted approach. Practices should implement structured follow-up protocols, including regular medication reviews and targeted patient education about the importance of consistent dosing. Clinical pharmacists within the PCN can conduct medication reconciliation and adherence assessments. Electronic reminders via text messages or apps can help patients remember their doses. PCNs should develop shared protocols for identifying and supporting non-adherent patients, as missed doses can quickly reduce anticoagulation protection due to the shorter half-life compared to warfarin.

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