依杜沙班
达比加群
阿哌沙班
拜瑞妥
医学
华法林
加药
药效学
药代动力学
药理学
直接凝血酶抑制剂的发现与发展
抗凝剂
重症监护医学
出处
期刊:Springer International Publishing eBooks
[Springer Nature]
日期:2021-01-01
卷期号:: 27-40
标识
DOI:10.1007/978-3-030-74462-5_3
摘要
Direct oral anticoagulants (DOACs) have become available as an alternative to warfarin anticoagulation in non-valvular atrial fibrillation. The DOACs, dabigatran (a reversible direct thrombin inhibitor) and the direct factor Xa inhibitors rivaroxaban, apixaban, and edoxaban offer fixed dosing, more predictable pharmacokinetics and fewer interactions with drugs and food than warfarin. Results from clinical trials demonstrated an improved benefit-risk ratio, compared to warfarin, in a broad patient population. However, significant differences between the four DOACs in terms of pharmacokinetic and safety profile are observed and must be considered to personalize the therapy.Thus, in the present chapter are described the pharmacodynamic and pharmacokinetic characteristics of DOACs, parameters that can help to differentiate their use based on the patient’s characteristics. Such condition should also guide clinicians to prescribe the appropriate type and dosage of DOAC, without the laboratory monitoring of their anticoagulant activity.KeywordsPharmacokineticPharmacodynamicP-gpCYP450ADMEDabigatranRivaroxabanApixabanEdoxaban
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