Kemkes-Matthes B
Interdisziplinärer Schwerpunkt für Hämostaseologie, Universitätsklinikum Gießen und Marburg GmbH, Langhansstr. 2, 35392, Gießen, Deutschland.
Internist (Berl). 2017 Jun;58(6):585-597. doi: 10.1007/s00108-017-0243-y.
Since direct oral anticoagulants (DOAC) have become available, use of anticoagulant treatment has become easier and safer-for patients suffering from thromboembolic diseases as well as for patients with atrial fibrillation: Because of constant bioavailability, fixed dose regimen treatment is possible, monitoring not necessary and severe bleeding complications-particularly intracranial hemorrhages-rare in comparison to vitamin K anticoagulants. To gain all these advantages, it is essential to give DOAC in the correct dosage. Dose reduction of single DOAC has to be considered depending on underlying disease, body weight and renal function. DOAC are not allowed in patients with artificial heart valves, in pregnancy and in children. In case of severe bleeding complications under DOAC treatment, prothrombin complex concentrates is one treatment option. For dabigatran an antidote is available.
自从直接口服抗凝剂（DOAC）问世以来，抗凝治疗对于患有血栓栓塞性疾病的患者以及房颤患者而言变得更加简便和安全：由于其生物利用度恒定，可以采用固定剂量方案治疗，无需监测，而且与维生素K抗凝剂相比，严重出血并发症尤其是颅内出血很少见。为了获得所有这些优势，正确服用DOAC至关重要。必须根据基础疾病、体重和肾功能考虑降低单一DOAC的剂量。人工心脏瓣膜患者、孕妇和儿童禁用DOAC。在DOAC治疗期间发生严重出血并发症时，凝血酶原复合物浓缩剂是一种治疗选择。对于达比加群，有一种解毒剂可用。
