Toxin-induced Coagulopathy

Although warfarin and heparin have been mainstays of anticoagulation for almost 50 years, the recent introduction of multiple oral anticoagulants has led some practitioners to shift away from warfarin as the anticoagulant of choice for various diseases. Major advances have been made in targeting downstream clotting factors in the coagulation cascade, resulting in two major new classes of drugs: direct thrombin inhibitors and factor Xa inhibitors. Developed partially with the patient in mind, these drugs are taken orally and, because of their target specificity, have eliminated the need for routine blood monitoring, making them attractive to patients currently on warfarin.