Name of the Procedure:

Common Name: Andexxa Injection
Technical/Medical Term: Injection, coagulation factor Xa (recombinant), inactivated-zhzo (J7169)

Summary

Andexxa is an injection given to counteract the effects of certain anticoagulant medications that inhibit Factor Xa. It's often used in emergency situations to reverse life-threatening or uncontrolled bleeding.

Purpose

Medical Conditions:

• Emergency reversal of anticoagulation in patients treated with Factor Xa inhibitors. ##### Goals:
• Stop active bleeding
• Prevent further bleeding complications
• Stabilize the patient's condition

Indications

• Major bleeding episodes
• Urgent need for surgery or invasive procedures in patients on Factor Xa inhibitors
• Evidence of severe overdose with Factor Xa inhibitors

Preparation

Pre-Procedure Instructions:

• Inform the healthcare team about all medications and supplements you are taking.
• You may need to fast for a certain period before the procedure. ##### Diagnostic Tests:
• Blood tests to measure coagulation status and effectiveness of anticoagulation therapy.

Procedure Description

1. Preparation: Establish an IV line and prepare the appropriate dose of Andexxa based on the patient's coagulation status and body weight.
2. Injection: Administer Andexxa through the IV line over a recommended time period.
3. Monitoring: Continuous monitoring of vital signs and coagulation parameters during and after the administration.
4. Post-Injection Care: Observe for any signs of adverse reactions or complications.

Tools/Equipment

• IV line
• Syringes for the Andexxa injection
• Monitoring devices for vital signs and coagulation status

Anesthesia or Sedation

• Generally not required for this procedure.

Duration

The injection itself typically takes about 30 minutes to administer, but monitoring may extend for several hours.

Setting

• Hospital
• Intensive care unit (ICU)
• Emergency Department

Personnel

• Physicians (e.g. hematologists, emergency medicine specialists)
• Nurses
• Pharmacists

Risks and Complications

Common Risks:

• Infusion-related reactions (e.g., headache, dizziness)
• Nausea

Rare Risks:

• Blood clots
• Cardiac events
• Anaphylaxis

Management:

• Immediate medical intervention for any severe reactions.
• Close monitoring and supportive care for less severe side effects.

Benefits

• Rapid reversal of anticoagulation
• Reduction of bleeding complications
• Ability to undergo urgent surgical procedures safely

Recovery

Post-Procedure Care:

• Continuous monitoring for any adverse effects ##### Recovery Time:
• Varies based on the extent of the bleeding and the patient's overall condition
• Patients may need ongoing monitoring and follow-up appointments

Alternatives

Other Treatment Options:

• Use of blood products (e.g., plasma)
• Protamine sulfate (for heparin reversal, not specific to Factor Xa inhibitors)

Pros and Cons:

• Blood products may not be as quick or specific in reversal.
• Protamine sulfate is not effective against Factor Xa inhibitor-induced anticoagulation.

Patient Experience

• During the procedure, you might feel a slight prick from the IV insertion.
• Post-procedure monitoring ensures you are safe and stable.
• Minimal discomfort is expected, though you may feel fatigued or have mild side effects such as nausea.
• Pain management and comfort measures will be provided as needed.