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Forensic Medicine · Toxicology: dabigatran bleeding
Sample itemA patient on dabigatran has life-threatening gastrointestinal bleeding. Which agent specifically reverses its effect?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Idarucizumab
Idarucizumab is a monoclonal antibody fragment that binds dabigatran and neutralises it. Protamine reverses heparin, vitamin K reverses warfarin and andexanet reverses factor Xa inhibitors such as rivaroxaban and apixaban.
Option by option
A. Protamine sulphate
Protamine reverses heparin, not dabigatran.
B. Idarucizumab (correct)
Correct. Idarucizumab specifically binds dabigatran.
C. Andexanet alfa
Andexanet reverses factor Xa inhibitors, not the thrombin inhibitor dabigatran.
D. Vitamin K
Vitamin K reverses vitamin K antagonists.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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