Reversal and Reinitiation of Anticoagulation

Bleeding emergencies demand decisive action. This 2024 module helps you synthesize the latest trials and society guidance into clear bedside algorithms for ICH, GI bleeding, and urgent surgery. Recognize the right antidotes—vitamin K with 4F‑PCC, andexanet alfa, idarucizumab—summarize practical dosing, understand lab interpretation, assess rebleeding and thrombotic risk, and determine safe restart timing to improve outcomes.

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Availability

On-Demand

Expires on Jul 30, 2027

Cost

Member: $0.00

Non-Member: $95.00

Credit Offered

2 CME Credits

2 ABIM-MOC Points

2 Participation Credits

Overview
Faculty
Accreditation
Recommended

Learning Objectives
After completing this activity, learners should be able to:

Recognize the mechanisms of action of available agents for reversal of anticoagulant effects of warfarin and direct-acting oral anticoagulants (DOACs).
Summarize pertinent clinical studies comparing agents for reversal of anticoagulant effect.
Understand strategies for rapid reversal of anticoagulation in ICH, GI bleeding, and before urgent surgery.
Assess the risk of rebleeding after ICH and GI bleeding.
Determine timing of anticoagulation resumption after ICH and GI bleeding.

If you are a Program Director and would like to grant access to your trainees, please reach out to education@hospitalmedicine.org for an academic access code.

Faculty

Mehraneh Khalighi
Becca Engels, MD
Scott Kaatz, DO, MSc, SFHM
- Dr. Kaatz reports working as a consultant for Bayer Pharmaceuticals, Inari, Anthos, AstraZeneca, and Gilead Sciences, Inc.
Lily Ackermann, ScM, MD, FACS, SFHM
Kurt Pfeifer, MD, FACP, SFHM, DFPM
Leonard Feldman, MD, FACP, FAAP, MHM

Faculty Disclosures
The individuals in control of content for this activity have no relevant relationships with ACCME-defined ineligible companies to disclose unless listed here. Any relevant relationships were mitigated prior to the start of this activity.

Accreditation Statement
The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CME Credit Statement
The Society of Hospital Medicine designates this enduring material for a maximum of 2.00 AMA PRA Category 1 Credit(s)^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

MOC Credit Statement
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

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