Managing Drug Interactions with Direct Oral Anticoagulants
Course #95010 - $15 -
- Participation Instructions
- Review the course material online or in print.
- Complete the course evaluation.
- Review your Transcript to view and print your Certificate of Completion. Your date of completion will be the date (Pacific Time) the course was electronically submitted for credit, with no exceptions. Partial credit is not available.
Direct oral anticoagulants (DOACs) are often used if oral anticoagulation is required, such as to prevent thromboembolism for patients with nonvalvular atrial fibrillation or for treatment and prevention of venous thromboembolism. One advantage of DOACs is their predictable response and limited need for routine laboratory monitoring. However, drug-drug interactions with these agents are common and may increase the risk of bleeding or thrombosis. Important DOAC interactions are often due to medications that affect increase bleeding propensity or cytochrome P450 (CYP450) enzymes or transport proteins. Clinicians require practical considerations for managing common drug interactions involving DOACs.
This course is designed for physicians, physician assistants, and nurses involved in the care of patients who require anticoagulation therapy.
The purpose of this course is to provide prescribers and other healthcare professionals with the knowledge and skills necessary to identify and act to avoid or address drug-drug interactions that occur in patients taking direct oral anticoagulants.
Upon completion of this course, you should be able to:
- Summarize common mechanisms of drug interactions with direct oral anticoagulants.
- Identify commonly used medications that may increase or decrease the effects of direct oral anticoagulants.
- Implement appropriate management of drug interactions with direct oral anticoagulants.
Jeff Langford, PharmD, BCPS-AQ Cardiology, BCCP, is a board-certified cardiology pharmacist with strong clinical, teaching, and interpersonal skills developed through experience in both inpatient and outpatient pharmacy. Dr. Langford is an Assistant Editor at TRC Healthcare and adjunct assistant professor at University of South Carolina College of Pharmacy. His inpatient practice includes focus in cardiovascular pharmacotherapy, and his outpatient practice includes extensive patient interaction and departmental management experience.
Contributing faculty, Jeff Langford, PharmD, BCPS-AQ Cardiology, BCCP, has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
John M. Leonard, MD
Mary Franks, MSN, APRN, FNP-C
Randall L. Allen, PharmD
The division planners have disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
Sarah Campbell
The Director of Development and Academic Affairs has disclosed no relevant financial relationship with any product manufacturer or service provider mentioned.
The purpose of NetCE is to provide challenging curricula to assist healthcare professionals to raise their levels of expertise while fulfilling their continuing education requirements, thereby improving the quality of healthcare.
Our contributing faculty members have taken care to ensure that the information and recommendations are accurate and compatible with the standards generally accepted at the time of publication. The publisher disclaims any liability, loss or damage incurred as a consequence, directly or indirectly, of the use and application of any of the contents. Participants are cautioned about the potential risk of using limited knowledge when integrating new techniques into practice.
It is the policy of NetCE not to accept commercial support. Furthermore, commercial interests are prohibited from distributing or providing access to this activity to learners.
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The role of implicit biases on healthcare outcomes has become a concern, as there is some evidence that implicit biases contribute to health disparities, professionals' attitudes toward and interactions with patients, quality of care, diagnoses, and treatment decisions. This may produce differences in help-seeking, diagnoses, and ultimately treatments and interventions. Implicit biases may also unwittingly produce professional behaviors, attitudes, and interactions that reduce patients' trust and comfort with their provider, leading to earlier termination of visits and/or reduced adherence and follow-up. Disadvantaged groups are marginalized in the healthcare system and vulnerable on multiple levels; health professionals' implicit biases can further exacerbate these existing disadvantages.
Interventions or strategies designed to reduce implicit bias may be categorized as change-based or control-based. Change-based interventions focus on reducing or changing cognitive associations underlying implicit biases. These interventions might include challenging stereotypes. Conversely, control-based interventions involve reducing the effects of the implicit bias on the individual's behaviors. These strategies include increasing awareness of biased thoughts and responses. The two types of interventions are not mutually exclusive and may be used synergistically.