直接口服抗凝剂在日常实践中的应用。
Use of direct oral anticoagulants in daily practice.
作者信息
Almarshad Feras, Alaklabi Ali, Bakhsh Ebtisam, Pathan Aslam, Almegren Mosaad
机构信息
College of Medicine, Shaqra University Shaqra, Saudi Arabia.
Department of Medicine, King Abdulaziz Medical City Riyadh, Saudi Arabia.
出版信息
Am J Blood Res. 2018 Dec 10;8(4):57-72. eCollection 2018.
Abstract
In recent years, the options for anticoagulant therapy have examined new direct oral anticoagulants (DOACs) comprising direct thrombin inhibitors (dabigatran) and direct factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban). These agents represent further progress towards the ideal anticoagulant drug and thus towards a safe and effective antithrombotic therapy. The ideal anticoagulant is oral and has a wide therapeutic range, predictable pharmacokinetics and pharmacodynamics, a rapid onset of action, an available antidote, minimal side effects, and minimal interactions with other drugs or food. This review addresses the practical considerations for physicians in DOAC use, including indication, dosage, monitoring, pharmacokinetic profile, drug-drug interaction, and reversal of direct anticoagulation effects in case of bleeding.
摘要
近年来，抗凝治疗的选择已考察了新型直接口服抗凝剂（DOACs），包括直接凝血酶抑制剂（达比加群）和直接因子Xa抑制剂（利伐沙班、阿哌沙班和依度沙班）。这些药物代表了朝着理想抗凝药物以及安全有效的抗血栓治疗取得的进一步进展。理想的抗凝剂是口服的，具有广泛的治疗范围、可预测的药代动力学和药效学、快速起效、有可用的解毒剂、副作用最小，并且与其他药物或食物的相互作用最小。本综述阐述了医生在使用DOAC时的实际考量，包括适应证、剂量、监测、药代动力学特征、药物相互作用以及出血时直接抗凝作用的逆转。
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