Division of Hematology and Oncology, University of New Mexico, USA.
Thromb Res. 2011 Sep;128(3):210-5. doi: 10.1016/j.thromres.2011.04.011. Epub 2011 May 12.
Vitamin K antagtonists (VKAs) have, for decades, been the corner-stone of anticoagulation in the outpatient setting. While the long half life makes once daily administration practical, close monitoring of VKA effect is necessary because these medicines have a narrow therapeutic index. Despite inter-individual variations in response to VKA doses, the increasing availability of specialized anticoagulation monitoring systems, along with a better understanding of potential drug and dietary interactions, has made the use of VKAs safer and less burdensome. In the future, newer classes of oral anticoagulants and genomic-based dosing strategies may further expand or improve the management options for many patients at risk for thromboembolism.
几十年来，维生素 K 拮抗剂 (VKAs) 一直是门诊抗凝治疗的基石。虽然半衰期长使得每日一次的给药成为可能，但由于这些药物的治疗指数较窄，因此需要密切监测 VKA 的效果。尽管个体对 VKA 剂量的反应存在差异，但随着专门的抗凝监测系统的日益普及以及对潜在药物和饮食相互作用的更好理解，VKA 的使用变得更加安全且负担更小。未来，新型口服抗凝药物和基于基因组的给药策略可能会进一步扩大或改善许多有血栓栓塞风险患者的管理选择。
