Monga anticoagulant yatsopano yapakamwa, rivaroxaban yakhala ikugwiritsidwa ntchito kwambiri popewa komanso kuchiza matenda a venous thromboembolic komanso kupewa sitiroko mu non-valvular atrial fibrillation. Kuti mugwiritse ntchito rivaroxaban momveka bwino, muyenera kudziwa mfundo zitatu izi.
I. Kusiyana pakati pa rivaroxaban ndi ma anticoagulants ena oral Pakali pano, mankhwala omwe amagwiritsidwa ntchito kwambiri pakamwa amaphatikizapo warfarin, dabigatran, rivaroxaban ndi zina zotero. Mwa iwo, dabigatran ndi rivaroxaban amatchedwa new oral anticoagulants (NOAC). Warfarin, makamaka imakhala ndi anticoagulant zotsatira zake poletsa kaphatikizidwe wa coagulation factor II (prothrombin), VII, IX ndi X. Warfarin alibe mphamvu pakupanga coagulation zinthu motero amakhala pang'onopang'ono kuchitapo kanthu. Dabigatran, makamaka kudzera pakuletsa mwachindunji kwa thrombin (prothrombin IIa) ntchito, imakhala ndi anticoagulant effect. Rivaroxaban, makamaka poletsa ntchito ya coagulation factor Xa, motero kuchepetsa kupanga thrombin (coagulation factor IIa) kuti agwiritse ntchito anticoagulant effect, sikumakhudza ntchito ya thrombin yopangidwa kale, choncho imakhala ndi zotsatira zochepa pa ntchito ya thupi la hemostasis.
2. Zizindikiro zachipatala za rivaroxaban vascular endothelial kuvulala, kuthamanga kwa magazi pang'onopang'ono, hypercoagulability ya magazi ndi zinthu zina zingayambitse thrombosis. Odwala ena a mafupa, opaleshoni ya m'chiuno kapena mawondo imakhala yopambana kwambiri, koma mwadzidzidzi amafa akadzuka pabedi patatha masiku angapo opaleshoniyo. Izi zili choncho chifukwa wodwalayo anayamba kudwala kwambiri mtsempha wa mtsempha atachitidwa opaleshoniyo n’kufa chifukwa cha kutsekeka kwa m’mapapo chifukwa cha thrombosis yomwe inatuluka. Rivaroxaban, wavomerezedwa kuti agwiritsidwe ntchito kwa odwala akuluakulu omwe akuchitidwa opaleshoni ya chiuno kapena mawondo kuti ateteze venous thrombosis (VTE); komanso pochiza deep vein thrombosis (DVT) mwa akuluakulu kuti achepetse chiopsezo cha DVT kubwereranso ndi pulmonary embolism (PE) pambuyo pa DVT yovuta. Atrial fibrillation ndi matenda amtima omwe amapezeka kwambiri mwa anthu opitilira zaka 75. Odwala omwe ali ndi vuto la atria amakhala ndi chizolowezi choti magazi asamayende bwino mu atria ndikupanga ziphuphu, zomwe zimatha kutulutsa ndikuyambitsa zikwapu. Rivaroxaban, yavomerezedwa ndikulimbikitsidwa kwa odwala akuluakulu omwe ali ndi vuto lopanda valvular atrial fibrillation kuti achepetse chiopsezo cha stroke ndi systemic embolism. Kuchita bwino kwa rivaroxaban sikotsika poyerekeza ndi warfarin, kuchuluka kwa magazi a intracranial ndi otsika kuposa warfarin, ndipo kuyang'anira chizolowezi cha anticoagulation sikufunika, ndi zina zotero.
3. Mphamvu ya anticoagulant ya rivaroxaban ndi yodziwikiratu, yokhala ndiwindo lalikulu lachirengedwe, palibe kudzikundikira pambuyo pa mlingo wambiri, komanso kusagwirizana kochepa ndi mankhwala ndi zakudya, kotero kuyang'anitsitsa nthawi zonse sikuli kofunikira. Pazochitika zapadera, monga kuganiziridwa mowonjezereka, zochitika zazikulu za magazi, opaleshoni yadzidzidzi, kuchitika kwa thromboembolic zochitika kapena kuganiziridwa kuti simunatsatire bwino, kutsimikiza kwa nthawi ya prothrombin (PT) kapena kutsimikiza kwa anti-factor Xa ntchito kumafunika. Malangizo: Rivaroxaban imapangidwa makamaka ndi CYP3A4, yomwe ndi gawo lapansi la mapuloteni a transporter P-glycoprotein (P-gp). Choncho, rivaroxaban sayenera kugwiritsidwa ntchito limodzi ndi itraconazole, voriconazole ndi posaconazole.