CRNAs provide care for patients treated with factor Xa inhibitors (e.g. rivaroxaban, apixaban) presenting for emergency surgery who are at risk perioperative hemorrhage. (1) Andexanet alfa is the first-in-class reversal agent (i.e. antidote) for rivaroxaban and apixaban induced anticoagulation in patients with uncontrolled hemorrhage. (2-4) This presentation will familiarize CRNAs with the following pharmacology, safety, and associated anesthetic implications related to the clinical use of andexanet alfa: medicinal chemistry, pharmacokinetics, pharmacodynamics, indication and usage, recommended dosage, warnings and precautions, adverse effects, and clinical studies.