Mehta Adwait, Burkland David, Mathuria Nilesh
Texas Heart Institute.
Baylor College of Medicine, Texas, USA.
Clin Pract. 2019 Jan 30;9(1):1096. doi: 10.4081/cp.2019.1096. eCollection 2019 Jan 29.
Direct oral anticoagulants have become increasingly used for atrial fibrillation and venothromboembolic disease. Thus far, there have been a few published cases of pericardial effusion associated with rivaroxban. However, there has been little published regarding the effects of concurrent medications and their effect on the cytochrome enzyme systems involved in rivaroxaban metabolism. We present a case of a 76-year-old female who develops a spontaneous haemopericardium after initiating rivaroxaban. After thorough medical reconciliation, we offer pharmacokinetic mechanisms that may have contributed to the haemopericardium. This case demonstrates the importance of reviewing patients medication lists and utilizing basic pharmacokinetics to prevent adverse events.
直接口服抗凝剂在心房颤动和静脉血栓栓塞性疾病中的应用越来越广泛。到目前为止，已有少数关于利伐沙班相关心包积液的病例报道。然而，关于同时使用的药物及其对参与利伐沙班代谢的细胞色素酶系统的影响，鲜有文献发表。我们报告一例76岁女性患者，在开始使用利伐沙班后发生自发性心包积血。经过全面的药物核对，我们提出了可能导致心包积血的药代动力学机制。该病例表明了审查患者用药清单和利用基本药代动力学来预防不良事件的重要性。
