A 63-year-old on apixaban for AF requires urgent laparotomy. Last dose was 8 hours ago; eGFR 85. What reversal strategy is appropriate for life‑threat...

Question

A 63-year-old on apixaban for AF requires urgent laparotomy. Last dose was 8 hours ago; eGFR 85. What reversal strategy is appropriate for life‑threatening bleeding/urgent surgery?

Accepted Answer

Andexanet alfa (if available) or 4‑factor PCC for factor Xa inhibitor reversal

Answer

Vitamin K only

Answer

Fresh frozen plasma only

Answer

Protamine sulfate

Answer

No reversal is possible

DOAC Reversal - Urgent Surgery — MRCP Part 1 MCQ

A 63-year-old on apixaban for AF requires urgent laparotomy. Last dose was 8 hours ago; eGFR 85. What reversal strategy is appropriate for life‑threatening bleeding/urgent surgery?