A patient is brought into the emergency room suffering from shock like symptoms resulting from internal hemorrhage. The patients history indicates they have been taking an orally effective anticoagulant for prevention of DVT. The ER physician administers an antidote in two doses 15 minutes apart, causing the patients clotting time to improve to near normal values within 30 minutes, and consequent improvement of the patient's hemodynamic status over the next 24 hours. What anticoagulant had this patient most likely been taking? Question 1Answer a. Aspirin b. Heparin c. Dabigatran d. Clopidogrel e. Enoxaparin

The patient was most likely taking the oral anticoagulant dabigatran. Dabigatran is a direct thrombin inhibitor that can be rapidly reversed with idarucizumab, an antidote that restores normal clotting times within 30 minutes.

Aspirin and clopidogrel are antiplatelet agents, not anticoagulants, and do not have specific reversal agents.

Heparin is an injectable anticoagulant that can be reversed with protamine sulfate. It is not orally effective.

Enoxaparin is a low-molecular-weight heparin injectable anticoagulant that also lacks an oral formulation.

Therefore, based on the rapid reversal of anticoagulation with a specific antidote and the improvement in hemodynamic status, dabigatran is the most likely anticoagulant the patient was taking.

Source:

-Hemorrhagic Shock - StatPearls - NCBI Bookshelf

-Hypovolemic Shock Treatment & Management - Medscape Reference

-Emergency Management of Major Bleeding in a Case of Maxillofacial ...

-Hypovolemic Shock: Causes, Symptoms & Diagnosis - Healthline

-Hemorrhage: Causes, Emergency Symptoms, First Aid & More