Wilcox Ryan, Pendleton Robert C, Smock Kristi J, Rodgers George M
Department of Medicine, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
Hosp Pract (1995). 2011 Aug;39(3):23-34. doi: 10.3810/hp.2011.08.576.
Dabigatran etexilate is an oral direct thrombin inhibitor that has been approved by the US Food and Drug Administration for the prevention of stroke and systemic embolization in patients with nonvalvular atrial fibrillation. It has also been studied for the prevention of venous thromboembolism in patients after hip and knee arthroplasty and for treatment of venous thromboembolism. Although routine laboratory monitoring is not needed, there are clinical scenarios in which physicians will need to have a clear understanding of drug pharmacology, laboratory assessment, and reversibility of this drug to make appropriate clinical decisions. We review the pharmacology of dabigatran etexilate, pertinent clinical trials, and the effects of dabigatran etexilate on prothrombin time, activated partial thromboplastin time, thrombin time, and ecarin clotting time. We also provide an approach to patients on dabigatran etexilate who are bleeding, have a suspected therapeutic failure, or require periprocedural management.
达比加群酯是一种口服直接凝血酶抑制剂，已获美国食品药品监督管理局批准，用于预防非瓣膜性心房颤动患者的中风和全身性栓塞。它也已被研究用于预防髋关节和膝关节置换术后患者的静脉血栓栓塞以及治疗静脉血栓栓塞。尽管不需要常规实验室监测，但在某些临床情况下，医生需要清楚了解该药物的药理学、实验室评估及可逆性，以便做出适当的临床决策。我们综述了达比加群酯的药理学、相关临床试验以及达比加群酯对凝血酶原时间、活化部分凝血活酶时间、凝血酶时间和蛇静脉酶凝结时间的影响。我们还提供了一种针对正在服用达比加群酯的出血患者、疑似治疗失败患者或需要围手术期管理患者的处理方法。
