Anticoagulation

1. Coag cascade

1.1. End product is fibrin which crosslink to hold the clot together

1.2. Major targets for ANTIcoag

1.2.1. Xa

1.2.1.1. Direct Factor Xa inhibitors

1.2.1.1.1. Rivaroxaban

1.2.1.1.2. Edoxaban

1.2.1.1.3. Apixaban

1.2.1.2. **Fondaparinux ** (indirect inhibitor)

1.2.1.3. **UFH**/LMWH

1.2.1.3.1. Enoxaparin

1.2.1.3.2. Dalteparin

1.2.2. Thrombin (IIa)

1.2.2.1. Direct thrombin inhibitors

1.2.2.1.1. **Argatroban** (IV)

1.2.2.1.2. **Bival** (IV)

1.2.2.1.3. **Dabigatran** (PO)

1.2.2.2. UFH/LMWH

1.2.3. **Warfarin** targets II, VII, IX, & X

2. DOACs v. warfarin

2.1. DOACs will generally be preferred for stroke prevention in AF & VTE tx

2.2. If mitral stenosis or mitral heart valve in AF, use warfarin

2.3. If antiphospholipid syndrome in VTE tx, use warfarin