Real Cases: Anticoagulant Management in Bleeding Patient

Dr. Joseph Shaw focuses this lecture on the management of anticoagulation in the actively bleeding patient, with an emphasis on translating pharmacology into safe, time-sensitive clinical decisions. Using a case-based approach, he reviews the pharmacology of direct oral anticoagulants (DOACs) and the mechanisms of anticoagulation reversal, including prothrombin complex concentrates (PCCs) and andexanet alfa. The discussion centers on practical decision-making in two high-risk scenarios: anticoagulation-associated bleeding and the need for urgent surgery, while carefully balancing the thrombotic risks associated with hemostatic therapies and reversal agents.

The lecture reinforces the importance of understanding both drug behavior and reversal strategies to guide evidence-based, patient-specific management in acute bleeding situations.