A 78-year-old man is discovered lifeless and sent to the medical room by ambulance. He has a complicated medical history and takes a number of drugs, but there are no known drug allergies, according to the family, who arrived first. Intracranial bleeding is discovered by non-contrast CT scanning of the head. The patient is given a recombinant biologic agent that has antigen homology with factor Xa but no catalytic effect. The agent is most likely to antagonize the effects of which of the following drugs?

Question

A 78-year-old man is discovered lifeless and sent to the medical room by ambulance. He has a complicated medical history and takes a number of drugs, but there are no known drug allergies, according to the family, who arrived first. Intracranial bleeding is discovered by non-contrast CT scanning of the head. The patient is given a recombinant biologic agent that has antigen homology with factor Xa but no catalytic effect.  The agent is most likely to antagonize the effects of which of the following drugs?

Quizplus · Accepted Answer

Eductional Objective: Andexanet alfa, a biologic medication that has similarities to factor Xa but does not have a proteolytic action, was probably used to treat the cerebral hemorrhage that this patient had. When a patient is on a factor Xa inhibitor and experiencing life-threatening bleeding, it is given to them (eg, rivaroxaban, apixaban). Andexanet can operate as a decoy that binds to factor Xa inhibitors because of how similar it is to factor Xa. This improves the availability of endogenous factor Xa, which turns prothrombin into thrombin and produces fibrin clots, and therefore restores intravascular coagulation. Andexanet is only used in cases of life-threatening bleeding since it carries a high risk of thrombosis.

A 78-Year-Old Man Is Discovered Lifeless and Sent to the Medical