@article{ref1,
title="Coagulation assays in a case of apixaban overdose",
journal="Blood coagulation and fibrinolysis",
year="2018",
author="Guadarrama, Dennis S. and DeMarinis, Sandra M. and Sweeney, Joseph D.",
volume="29",
number="2",
pages="231-235",
abstract="Intentional overdose of apixaban is rare and minimal data exist regarding the usefulness of routinely available laboratory tests to predict drug levels. A 50-year-old man was admitted after ingestion of 200-mg apixaban. Serial blood samples were obtained over a 54-h period for assessment of the fall-off in drug levels using the prothrombin time/international normalized ratio and anti-Xa assays and compared with an apixaban-specific chromogenic assay. The prothrombin time/international normalized ratio and anti-Xa assays correlated with the apixaban level when the drug was in the supratherapeutic range (>130 ng/ml) but not in the typical therapeutic trough to peak levels. Apixaban levels are best assessed by a specific anti-Xa test using optimized chromogenic substrates and specific calibrators. A standard anti-Xa test can be a useful surrogate when drug levels are high but use of a specific threshold level for discharge purposes requires caution.<p /> <p>Language: en</p>",
language="en",
issn="0957-5235",
doi="10.1097/MBC.0000000000000706",
url="http://dx.doi.org/10.1097/MBC.0000000000000706"
}