Njenge-anticoagulant yomlomo omtsha, i-rivaroxaban isetyenziswe ngokubanzi ekukhuselweni nasekunyangelweni kwesifo se-venous thromboembolic kunye nokukhusela i-stroke kwi-non-valvular atrial fibrillation.Ukuze usebenzise i-rivaroxaban ngokufanelekileyo, kufuneka wazi ubuncinane la manqaku e-3.
I. Umahluko phakathi kwe-rivaroxaban kunye nezinye ii-anticoagulants zomlomo Okwangoku, i-anticoagulants yomlomo esetyenziswa ngokuqhelekileyo iquka i-warfarin, i-dabigatran, i-rivaroxaban kunye nokunye.Phakathi kwabo, i-dabigatran kunye ne-rivaroxaban zibizwa ngokuba yi-anticoagulants yomlomo entsha (NOAC).I-Warfarin, ngokuyinhloko yenza i-anticoagulant effect ngokuvimbela ukuhlanganiswa kwezinto ze-coagulation II (prothrombin), i-VII, i-IX kunye ne-X. I-Warfarin ayinayo impembelelo kwizinto ezidibeneyo ze-synthesized coagulation kwaye ngoko ke inokuqala kancinci kwesenzo.I-Dabigatran, ngokukodwa ngokuthintela ngokuthe ngqo kwe-thrombin (prothrombin IIa) umsebenzi, yenza i-anticoagulant effect.I-Rivaroxaban, ngokukodwa ngokuthintela umsebenzi we-coagulation factor Xa, ngoko ke ukunciphisa ukuveliswa kwe-thrombin (i-coagulation factor IIa) ukwenza i-anticoagulant effect, ayichaphazeli umsebenzi we-thrombin esele iveliswe, kwaye ngoko ke inempembelelo encinci kumsebenzi we-physiological hemostasis.
2. Izibonakaliso zeklinikhi ze-rivaroxaban vascular endothelial injury, ukuhamba ngokukhawuleza kwegazi, i-hypercoagulability yegazi kunye nezinye izinto ezinokubangela i-thrombosis.Kwezinye izigulane zamathambo, utyando lokutshintshwa kwe-hip okanye idolo luphumelele kakhulu, kodwa ngokukhawuleza bafa xa bephuma ebhedini emva kweentsuku ezimbalwa emva kokuhlinzwa.Oku kunokwenzeka ngenxa yokuba isigulana siye saba ne-thrombosis enzulu ye-vein emva kotyando kwaye safa ngenxa ye-pulmonary embolism ebangelwa yi-thrombus ekhutshiweyo.I-Rivaroxaban, ivunyiwe ukuba isetyenziswe kwizigulane ezikhulileyo ezithatha utyando lokutshintshwa kwe-hip okanye idolo ukukhusela i-venous thrombosis (VTE);kunye nokunyangwa kwe-thrombosis ye-vein deep (DVT) kubantu abadala ukunciphisa umngcipheko wokuphindaphinda kwe-DVT kunye ne-pulmonary embolism (PE) emva kwe-DVT enzima.I-fibrillation ye-Atrial yi-arrhythmia ye-cardiac eqhelekileyo kunye nokuxhaphaka ukuya kwi-10% kubantu abangaphezu kweminyaka engama-75 ubudala.Izigulane ezine-fibrillation ye-atrial zivame ukuba igazi lizinzile kwi-atria kwaye zenze amahlwili, anokuthi akhuphe kwaye akhokelele kwi-stroke.I-Rivaroxaban, ivunyiwe kwaye icetyiswa kwizigulane zabantu abadala abane-non-valvular atrial fibrillation ukunciphisa umngcipheko we-stroke kunye ne-systemic embolism.Ukusebenza kwe-rivaroxaban akukho ngaphantsi kwe-warfarin, iziganeko ze-intracranial hemorrhage zingaphantsi kunezo ze-warfarin, kwaye ukubekwa iliso okuqhelekileyo kwe-anticoagulation intensity ayifuni, njl njl.
3. Umphumo we-anticoagulant we-rivaroxaban unokuqikelelwa, kunye nefestile yonyango ebanzi, akukho kuqokelela emva kweedosi ezininzi, kunye nokusebenzisana okumbalwa kunye neziyobisi kunye nokutya, ngoko ke ukujongwa kwe-coagulation rhoqo akuyimfuneko.Kwiimeko ezikhethekileyo, ezifana nokugqithisa okukrokrelwayo, iziganeko ezinzulu zokopha, utyando olungxamisekileyo, ukwenzeka kweziganeko ze-thromboembolic okanye ukukrokrelwa ukuthotyelwa kokuthobela, ukuzimisela kwexesha le-prothrombin (PT) okanye ukuzimisela kwe-anti-factor Xa umsebenzi kuyadingeka.Iingcebiso: I-Rivaroxaban i-metabolized ikakhulu yi-CYP3A4, eyona nto i-substrate ye-protein ye-transporter P-glycoprotein (P-gp).Ngoko ke, i-rivaroxaban akufanele isetyenziswe ngokudibanisa ne-itraconazole, i-voriconazole kunye ne-posaconazole.