Ma ke ʻano he anticoagulant waha hou, ua hoʻohana nui ʻia ʻo rivaroxaban i ka pale ʻana a me ka mālama ʻana i ka maʻi thromboembolic venous a me ka pale ʻana i ka hahau i ka fibrillation atrial non-valvular. I mea e hoʻohana pono ai i ka rivaroxaban, pono ʻoe e ʻike i kēia mau helu 3.
I. ʻO ka ʻokoʻa ma waena o rivaroxaban a me nā anticoagulants waha ʻē aʻe I kēia manawa, ʻo nā anticoagulants waha i hoʻohana mau ʻia me warfarin, dabigatran, rivaroxaban a pēlā aku. I waena o lākou, ua kapa ʻia ʻo dabigatran a me rivaroxaban i nā anticoagulants waha hou (NOAC). ʻO Warfarin, hoʻohana nui i kāna hopena anticoagulant ma ke kāohi ʻana i ka synthesis o nā mea coagulation II (prothrombin), VII, IX a me X. ʻAʻohe hopena o Warfarin i nā kumu coagulation synthesized a no laila he lohi ka hoʻomaka ʻana o ka hana. ʻO Dabigatran, ka mea nui ma o ke kāohi pololei ʻana i ka hana thrombin (prothrombin IIa), hoʻohana i ka hopena anticoagulant. ʻO Rivaroxaban, ka mea nui ma ke kāohi ʻana i ka hana o ka coagulation factor Xa, no laila e hōʻemi ana i ka hana ʻana o ka thrombin (coagulation factor IIa) e hoʻokō i ka hopena anticoagulant, ʻaʻole pili i ka hana o ka thrombin i hana mua ʻia, a no laila he liʻiliʻi ka hopena i ka hana hemostasis physiological.
2. ʻO nā hōʻailona hōʻailona o rivaroxaban vascular endothelial hōʻeha, lohi i ke kahe o ke koko, hypercoagulability koko a me nā mea ʻē aʻe hiki ke hoʻoulu i ka thrombosis. I kekahi poʻe maʻi orthopedic, ʻoi aku ka maikaʻi o ke ʻoki ʻana i ka ʻūhā a i ʻole ke kuli, akā make koke lākou i ka wā e haʻalele ai lākou mai kahi moe i kekahi mau lā ma hope o ke kaʻina. Ma muli paha o ka loaʻa ʻana o ka thrombosis vein hohonu ka mea maʻi ma hope o ke ʻoki ʻana a make ma muli o ka pulmonary embolism i hoʻokumu ʻia e ka thrombus dislodged. Ua ʻae ʻia ʻo Rivaroxaban no ka hoʻohana ʻana i nā poʻe maʻi makua e hana ana i ka ʻokiʻoki ʻāʻī a i ʻole ke kuli e pale ai i ka thrombosis venous (VTE); a no ka mālama ʻana i ka thrombosis vein hohonu (DVT) i nā pākeke e hōʻemi i ka pilikia o ka hoʻi hou ʻana o ka DVT a me ka pulmonary embolism (PE) ma hope o ka DVT acute. ʻO ka fibrillation atrial kahi arrhythmia cardiac maʻamau me ka piʻi ʻana o ka 10% i nā poʻe ma mua o 75 mau makahiki. ʻO ka poʻe maʻi me ka atrial fibrillation he maʻamau ke koko e stagnate i loko o ka atria a hana i nā clots, hiki ke hoʻokuʻu a alakaʻi i nā hahau. ʻO Rivaroxaban, ua ʻae ʻia a paipai ʻia no nā poʻe maʻi makua me ka fibrillation atrial non-valvular e hōʻemi i ka hopena o ka hahau a me ka embolism systemic. ʻAʻole haʻahaʻa ka maikaʻi o rivaroxaban i ka warfarin, ʻoi aku ka haʻahaʻa o ka hemorrhage intracranial ma mua o ka warfarin, a ʻaʻole pono ka nānā ʻana i ka ikaika anticoagulation, etc.
3. Hiki ke ʻike ʻia ka hopena anticoagulant o rivaroxaban, me ka puka aniani therapeutic ākea, ʻaʻohe hōʻiliʻili ma hope o ka nui o nā doses, a liʻiliʻi nā pilina me nā lāʻau a me nā meaʻai, no laila ʻaʻole pono ka nānā ʻana i ka coagulation maʻamau. I nā hihia kūikawā, e like me ka overdose i manaʻo ʻia, nā hanana koko koʻikoʻi, ka hōʻeha pilikia, ka hanana ʻana o nā hanana thromboembolic a i ʻole ka hoʻokō pono ʻole ʻia, ka hoʻoholo ʻana i ka manawa prothrombin (PT) a i ʻole ka hoʻoholo ʻana i ka hana anti-factor Xa. Manaʻo kōkua: ʻO Rivaroxaban ka nui o ka metabolized e CYP3A4, ʻo ia ka substrate o ka transporter protein P-glycoprotein (P-gp). No laila, ʻaʻole pono e hoʻohana ʻia ka rivaroxaban me ka itraconazole, voriconazole a me posaconazole.