Raws li ib tug tshiab qhov ncauj anticoagulant, rivaroxaban tau dav siv nyob rau hauv kev tiv thaiv thiab kev kho mob ntawm venous thromboembolic kab mob thiab kev tiv thaiv mob stroke nyob rau hauv uas tsis yog-valvular atrial fibrillation.Txhawm rau siv rivaroxaban ntau qhov tsim nyog, koj yuav tsum paub tsawg kawg 3 cov ntsiab lus no.
I. Qhov sib txawv ntawm rivaroxaban thiab lwm yam tshuaj tiv thaiv qhov ncauj tam sim no, cov tshuaj tiv thaiv qhov ncauj feem ntau siv xws li warfarin, dabigatran, rivaroxaban thiab lwm yam.Ntawm lawv, dabigatran thiab rivaroxaban yog hu ua tshiab qhov ncauj anticoagulants (NOAC).Warfarin, feem ntau exerts nws anticoagulant nyhuv los ntawm inhibiting lub synthesis ntawm coagulation yam II (prothrombin), VII, IX thiab X. Warfarin tsis muaj kev cuam tshuam rau cov synthesized coagulation yam thiab yog li ntawd muaj ib tug qeeb pib ntawm kev ua.Dabigatran, tshwj xeeb tshaj yog los ntawm kev cuam tshuam ncaj qha ntawm thrombin (prothrombin IIa), ua rau cov nyhuv anticoagulant.Rivaroxaban, feem ntau yog los ntawm inhibiting cov kev ua ntawm coagulation factor Xa, yog li txo cov zus tau tej cov thrombin (coagulation factor IIa) kom muaj zog anticoagulant nyhuv, tsis cuam tshuam rau cov kev ua ntawm twb tsim thrombin, thiab yog li ntawd muaj me ntsis cuam tshuam rau lub physiological hemostasis muaj nuj nqi.
2. Cov ntaub ntawv kho mob ntawm rivaroxaban vascular endothelial raug mob, ntshav khiav qeeb, ntshav hypercoagulability thiab lwm yam tuaj yeem ua rau thrombosis.Hauv qee cov neeg mob orthopedic, kev phais lub duav lossis lub hauv caug hloov tau zoo heev, tab sis lawv mam li tuag thaum lawv tawm ntawm txaj ob peb hnub tom qab kev phais.Qhov no yuav yog vim tias tus neeg mob tau tsim cov hlab ntsha sib sib zog nqus tom qab kev phais thiab tuag vim yog pulmonary embolism tshwm sim los ntawm cov thrombus dislodged.Rivaroxaban, tau pom zoo siv rau hauv cov neeg laus cov neeg mob uas tau phais lub duav lossis lub hauv caug hloov los tiv thaiv venous thrombosis (VTE);thiab rau kev kho mob ntawm cov hlab ntsha sib sib zog nqus thrombosis (DVT) hauv cov neeg laus kom txo tau qhov kev pheej hmoo ntawm DVT rov tshwm sim thiab pulmonary embolism (PE) tom qab mob DVT.Atrial fibrillation yog ib qho mob plawv arrhythmia uas muaj ntau txog 10% hauv cov neeg muaj hnub nyoog tshaj 75 xyoo.Cov neeg mob uas muaj atrial fibrillation muaj ib qho kev nyiam rau cov ntshav stagnate nyob rau hauv lub atria thiab tsim cov hlab ntsha, uas tuaj yeem cuam tshuam thiab ua rau mob stroke.Rivaroxaban, tau txais kev pom zoo thiab pom zoo rau cov neeg laus uas tsis yog-valvular atrial fibrillation los txo txoj kev pheej hmoo ntawm mob stroke thiab kab mob embolism.Qhov kev ua tau zoo ntawm rivaroxaban tsis yog qhov qis dua ntawm warfarin, qhov tshwm sim ntawm intracranial hemorrhage qis dua li ntawm warfarin, thiab kev saib xyuas niaj hnub ntawm kev siv tshuaj tiv thaiv coagulation tsis tas, thiab lwm yam.
3. Cov nyhuv anticoagulant ntawm rivaroxaban yog kwv yees tau, nrog lub qhov rais kho dav dav, tsis muaj kev sib txuam tom qab ntau qhov koob tshuaj, thiab kev sib cuam tshuam nrog cov tshuaj thiab zaub mov, yog li kev soj ntsuam coagulation tsis tsim nyog.Nyob rau hauv cov xwm txheej tshwj xeeb, xws li xav tias overdose, los ntshav loj, kev phais xwm txheej ceev, tshwm sim ntawm cov xwm txheej thromboembolic lossis xav tias tsis ua raws cai, kev txiav txim siab ntawm lub sij hawm prothrombin (PT) lossis kev txiav txim siab ntawm kev tiv thaiv Xa kev ua haujlwm.Lub tswv yim: Rivaroxaban feem ntau yog metabolized los ntawm CYP3A4, uas yog substrate ntawm transporter protein P-glycoprotein (P-gp).Yog li, rivaroxaban yuav tsum tsis txhob siv ua ke nrog itraconazole, voriconazole thiab posaconazole.