Semumuromo mutsva anticoagulant, rivaroxaban yakashandiswa zvakanyanya mukudzivirira uye kurapwa kwechirwere chevenous thromboembolic uye kudzivirira sitiroko mune isiri-valvular atrial fibrillation.Kuti ushandise rivaroxaban zvakanyanya zvine musoro, iwe unofanirwa kuziva angangoita aya matatu mapoinzi.
I. Musiyano pakati pe rivaroxaban nemamwe anticoagulants oral Parizvino, iyo inowanzoshandiswa nemuromo anticoagulants inosanganisira warfarin, dabigatran, rivaroxaban nezvimwe zvakadaro.Pakati pavo, dabigatran uye rivaroxaban inonzi itsva oral anticoagulants (NOAC).Warfarin, inonyanya kushandisa maitiro ayo anticoagulant kuburikidza nekudzivisa kuumbwa kwe coagulation factor II (prothrombin), VII, IX uye X. Warfarin haina simba pane zvakagadziriswa coagulation zvinhu uye naizvozvo ine zvishoma nezvishoma.Dabigatran, kunyanya kuburikidza nekudzivisa zvakananga kwethrombin (prothrombin IIa) basa, inoshandisa anticoagulant effect.Rivaroxaban, kunyanya kuburikidza nekudzivisa basa rekugadzirisa coagulation factor Xa, nokudaro kuderedza kugadzirwa kwethrombin (coagulation factor IIa) kuti iite anticoagulant effect, haibatsiri basa rekutanga rakagadzirwa thrombin, uye naizvozvo haina zvishoma pane physiological hemostasis basa.
2. Zviratidzo zvekliniki zve rivaroxaban vascular endothelial kukuvara, kunonoka kweropa, hypercoagulability yeropa nezvimwe zvinhu zvinogona kukonzera thrombosis.Mune vamwe varwere vemapfupa, kuvhiyiwa kwehudyu kana mabvi kunobudirira zvikuru, asi vanofa kamwe kamwe pavanobuda pamubhedha mazuva mashomanana mushure mekuvhiyiwa.Izvi zvingangodaro nekuti murwere akagadzira yakadzika tsinga mushure mekuvhiyiwa uye akafa nekuda kwepulmonary embolism yakakonzerwa neiyo thrombus yakadzingwa.Rivaroxaban, yakagamuchirwa kuti ishandiswe muvarwere vakura vanovhiyiwa hudyu kana mabvi kuti vadzivirire venous thrombosis (VTE);uye yekurapa yakadzika vein thrombosis (DVT) muvanhu vakuru kuderedza dambudziko reDVT kudzokorora uye pulmonary embolism (PE) mushure meDVT yakaoma.Atrial fibrillation ndiyo yakajairika cardiac arrhythmia ine kupararira kunosvika gumi muzana muvanhu vanopfuura makore makumi manomwe nemashanu.Varwere vane atrial fibrillation vane tsika yekuti ropa rimire muatria uye kuumba magwamba, anogona kudonha uye kutungamirira kune sitiroko.Rivaroxaban, yakagamuchirwa uye yakakurudzirwa kuvarwere vakuru vane non-valvular atrial fibrillation kuderedza dambudziko rekurohwa uye systemic embolism.Kubudirira kwe rivaroxaban hakusi kwakaderera kune iyo yewarfarin, chiitiko chekubuda ropa kwemukati chakaderera pane chewarfarin, uye nguva dzose kutarisa kwehutano hwehutachiona husingadiwi, nezvimwewo.
3. Iyo anticoagulant effect ye rivaroxaban inofanotaurwa, ine hwindo rakakura rekurapa, pasina kuunganidza mushure memaitiro akawanda, uye zvishomanana zvekubatana nemishonga uye zvokudya, saka nguva dzose coagulation monitoring haifaniri.Muzviitiko zvakakosha, zvakadai sekufungidzirwa kuwandisa, zviitiko zvakakomba zvekubuda ropa, kuvhiyiwa kwechimbichimbi, kuitika kwezviitiko zvethromboembolic kana kufungidzirwa kusateerera, kutsunga kweprothrombin nguva (PT) kana kutsunga kweanti-factor Xa chiitiko chinodiwa.Mazano: Rivaroxaban inonyanya kushandiswa neCYP3A4, iyo inonzi substrate ye transporter protein P-glycoprotein (P-gp).Nokudaro, rivaroxaban haifaniri kushandiswa pamwe chete ne itraconazole, voriconazole uye posaconazole.