Dealing with DOACs: A GI Guide to Anticoagulation

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Step Status
Starts On: 7/1/2019: 12:00 AM
Ends On: 6/30/2020: 12:00 AM
Session Type: Internet Activity Enduring Material
Credits: 0.5


Jean S. Wang, MD, PhD
Professor, Medicine Gastroenterology
Professor, Surgery
Financial Relationships: Noting to disclose

Presenters should indicate if speaking off label. This activity originated as a presentation at the CME activity, 16th Galaxy of Gastroenterology, November 2-3, 2018, which was supported in part by Synergy Pharmaceuticals Inc., Takeda Pharmaceuticals, and Olympus Corporation of the Americas.

Planning Committee

C. Prakash Gyawali, MD, MRCP, Course Chair
Financial Relationships:
Consulting/ Advisory Committees: Medtronic, Ironwood Pharmaceuticals, Torax, Quintiles
Research Support/Grants: Allergan, Inc, Ironwood Pharmaceuticals
Speakers' Bureaus/Honoraria: Diversitak, Medtronic

Gregory S. Sayuk, MD, MPH, Course Chair
Financial Relationships:
Consulting/ Advisory Committees: Synthetic Biologics, Synergy Pharmaceuticals
Speakers' Bureaus/Honoraria: Allergan, Inc

Jill Elwing, MD, Independent Reviewer
Financial Relationships: Reviewer has nothing to disclose

Laura Haroian, RN, MSN, Nurse Planner
Financial Relationships: Planner has nothing to disclose.

Gillian M. Powderly, PharmD, Pharmacist Planner
VA St. Louis Health Care System-John Cochran Division
Financial Relationships: Planner has nothing to disclose.

Objectives: The intended result of this activity is increased knowledge/competence, and upon completion of this course, participants should be able to:
  • Identify characteristics of direct oral anticoagulants (DOACs) including direct thrombin inhibitors and direct factor Xa inhibitors.
  • Implement appropriate management of DOACs before performing endoscopic procedures.
  • Evaluate anticoagulant reversal techniques in a bleeding patient.
  • Assess post-procedure management of anticoagulants.
Additional Information:
Target Audience: This course is designed for primary care physicians, gastroenterologists, gastrointestinal surgeons and their associates who participate in the care of patients with gastrointestinal and hepatic disorders. The course will also be of value to technicians, nurses and physicians who participate in endoscopy, gastrointestinal motility procedures, and pH-monitoring procedures.

Publication Date: July 1, 2019
Expiration Date: June 30, 2020

Accreditation Information:
In support of improving patient care, Washington University School of Medicine in St. Louis is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credit Awarded for this Activity:
Credit Statement:
American Medical Association (AMA Credit)
Washington University School of Medicine in St. Louis designates this enduring material for a maximum of .5 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

  • ASGE Guideline: ASGE Standards of Practice Committee, Acosta RD, Abraham NS, Chandrasekhara V, Chathadi KV, Early DS, Eloubeidi MA, Evans JA, Faulx AL, Fisher DA, Fonkalsrud L, Hwang JH, Khashab MA, Lightdale JR, Muthusamy VR, Pasha SF, Saltzman JR, Shaukat A, Shergill AK, Wang A, Cash BD, DeWitt JM. The management of antithrombotic agents for patients undergoing GI endoscopy. Gastrointest Endosc. 2016 Jan;83(1):3-16.
  • ACCP Guideline: Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schuünemann HJ; American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel. Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. CHEST 2012; 141(2)(Suppl):7S–47S.
  • ACC/AHA Guideline: Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA, Jneid H, Mack MJ, McLeod CJ, O'Gara PT, Rigolin VH, Sundt TM 3rd, Thompson A. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2017;70:252–89.
Disclosure Information: It is the policy of Washington University School of Medicine in St. Louis, Continuing Medical Education, to ensure balance, independence, objectivity and scientific rigor in all its educational activities. All planners, faculty and other persons who may influence content of this CME activity have disclosed all relevant financial relationships with commercial interests. All disclosures have been reported and are indicated with their presentations. Any potential conflicts were addressed and resolved.

Presenters are also expected to openly disclose inclusion of discussion of any off-label, experimental, or investigational use of drugs or devices in their presentations.

Presentations are expected to be based on evidence that is accepted within the profession of medicine as adequate justification for their indication in the care of patients. All scientific research should conform to the generally accepted standards of experimental design, data collection and analysis. These presentations are not an endorsement of any commercial interests.

These presentations are the views and experiences of the presenters. The presenters' views do not represent the policy or position of Washington University School of Medicine in St. Louis. Washington University School of Medicine in St. Louis, Continuing Medical Education, is the provider for CME credits.
Categories: Gastroenterology

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