I te mea he anticoagulant waha hou, kua whakamahia whanuitia te rivaroxaban ki te aukati me te maimoatanga o te mate thromboembolic venous me te aukati whiu i roto i te kore-valvular atrial fibrillation.Kia pai ake ai te whakamahi rivaroxaban, me mohio koe ki enei tohu e 3.
I. Ko te rereketanga i waenga i te rivaroxaban me etahi atu anticoagulants waha I tenei wa, ko nga anticoagulants waha e whakamahia ana ko te warfarin, te dabigatran, te rivaroxaban me etahi atu.I roto ia ratou, ko te dabigatran me te rivaroxaban e kiia ana ko nga anticoagulants waha hou (NOAC).Ko te Warfarin, ko te nuinga o nga mahi anticoagulant na roto i te aukati i te whakahiatotanga o nga take coagulation II (prothrombin), VII, IX me X. Karekau he painga o te Warfarin ki nga mea whakahiato whakahiato na reira he puhoi te tiimata o te mahi.Ko te Dabigatran, ko te nuinga ma te aukati tika i te mahi thrombin (prothrombin IIa), ka whai hua anticoagulant.Rivaroxaban, te nuinga na roto i te aukati i te mahi o te tauwehe coagulation Xa, na reira ka whakaiti i te hanga o te thrombin (coagulation factor IIa) ki te whai hua anticoagulant, kaore e pa ki te mahi o te thrombin kua puta, na reira he iti te paanga ki te mahi hemostasis tinana.
2. Ko nga tohu haumanu o rivaroxaban vascular endothelial whara, puhoi te rere toto, hypercoagulability toto me etahi atu mea ka puta te thrombosis.I etahi o nga turoro orthopedic, he tino angitu te pokanga whakakapi hiku, turi ranei, engari ka mate ohorere i te wa e heke mai ana i te moenga i etahi ra i muri i te pokanga.Ko te mea pea na te mea i whakawhanake te manawanui i te thrombosis uaua hohonu i muri i te pokanga, ka mate na te pulmonary embolism i puta mai i te thrombus kua heke.Rivaroxaban, kua whakaaetia mo te whakamahi i nga turoro pakeke e mahi ana i nga mahi whakakapi hipoki, turi ranei hei aukati i te thrombosis venous (VTE);a mo te maimoatanga o te thrombosis vein hohonu (DVT) i roto i nga pakeke ki te whakaiti i te tupono o te hokinga mai o te DVT me te pulmonary embolism (PE) i muri i te DVT whakapeka.Ko te whakahiatotanga o te atrial ko te arrhythmia ngakau noa me te nui o te mate ki te 10% i roto i nga tangata neke atu i te 75 tau te pakeke.Ko nga turoro e mate ana i te atrial fibrillation he ahua o te whakaheke toto i roto i te atria, ka hanga i nga toka, ka mawehe atu ka arahi ki nga whiu.Rivaroxaban, kua whakaaetia me te taunaki mo nga turoro pakeke me te kore-valvular atrial fibrillation ki te whakaiti i te mate o te whiu me te embolism pūnaha.Ko te whai hua o te rivaroxaban kaore i te iti ake i tera o te warfarin, he iti ake te mate o te whakaheke toto toto i tera o te warfarin, a, kaore e hiahiatia te aro turuki i te kaha o te anticoagulation, etc.
3. Ko te painga o te anticoagulant o rivaroxaban ka taea te tohu, me te matapihi rongoa whanui, kaore he kohinga i muri i nga pota maha, me te iti o nga taunekeneke me nga raau taero me te kai, na reira kaore e tika te aro turuki i te coagulation.I roto i nga keehi motuhake, penei i te whakapae he nui rawa atu, he toto toto nui, he pokanga ohorere, he paheketanga o te thromboembolic, he whakapae ngoikore ranei, te whakatau i te wa prothrombin (PT) me te whakatau i te mahi anti-taua Xa e hiahiatia ana.Tohutohu: Ko te Rivaroxaban te nuinga o te mea ka whakakorikorihia e CYP3A4, koinei te tïpako o te P-glycoprotein (P-gp) kawe.Na reira, kaua e whakamahia te rivaroxaban me te itraconazole, voriconazole me te posaconazole.