Pneumotox » Drug » Anticoagulants, direct oral (anti-thrombin, -IIa, -Xa) - NOAC

Anticoagulants, direct oral (anti-thrombin, -IIa, -Xa) - NOAC

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See under specific drugs. Initially called 'new' antocoagulants: e.g. anti-IIa: dabigatran. Anti-Xa: rivaroxaban, apixaban. Management, reversing agents and antidotes see under PMID 24275169, 27330657. Montitoring of DOAC activity at PMID 27637548. Antidotes and reversal agants at PMID 24275169, 26872887.

Last update : 23/10/2023

I.a Pneumonitis (ILD), acute and/or severe (may cause ARDS)

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I.b Pneumonitis (ILD)

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II.b ARDS - Acute lung injury

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III.a Alveolar hemorrhage (AH), diffuse AH (DAH)

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III.c Hemoptysis

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III.k Epistaxis

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III.m Coagulopathy

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V.e Hemothorax - Serosanguineous pleural effusion

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V.n Hemopericardium - Bloody pericardial effusion

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VIII.b Hematoma of/around central airway wall potentially causing UAO

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IX.x Thoracic epidural or spinal hematoma

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X.a DRES syndrome - DRESS-like reaction

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XVI.j Imaging: Wandering (migratory) pulmonary opacities

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Diagnosing DIRD

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Drug and radiation history

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Drug singularity - Correct identification of the drug

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Consistent timing of exposure v. onset of symptoms

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Clinical, imaging, BAL, pathological pattern consistent with the specific drug

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Careful exlusion of another cause

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Remission of symptoms with removal of drug

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Recurrence with rechallenge (rarely advisable)

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Causality assessment

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