Published: 22 July 2019
Author(s): William Gansheng Shi, Mark Crowther
Issue: July 2019
Section: Editorial

The direct oral anticoagulants (DOACs) (apixaban, rivaroxaban, betrixaban, edoxaban and dabigatran) have gradually replaced vitamin K antagonists (VKAs) as the mainstay anticoagulation therapy. However, lack of specific reversal agents has been consistently raised as a concern since the introduction of the DOACs. Major bleeding and invasive procedures are common clinical settings where DOAC reversal may be required; further a high frequency of co-morbid conditions makes it likely that patients treated with DOACs will require such interruptions of their therapy.

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The specialty of internal medicine covers a wide range of conditions affecting the internal organs of the body. Although some diseases specifically affect individual organs, the majority of common diseases. The internist must then be trained to recognise and manage a broad range of diseases and, with the aging population, many patients with chronic and multiple disorders.

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