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 amakhala ndi anticoagulant zotsatira zake poletsa kaphatikizidwe wa coagulation factor II (prothrombin), VII, IX ndi X. Warfarin alibe mphamvu pa synthesized coagulation zinthu choncho ali pang'onopang'ono isanayambike zochita.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.Kwa odwala ena a mafupa, opaleshoni ya m'chiuno kapena m'mawondo imakhala yopambana kwambiri, koma mwadzidzidzi amafa akadzuka pabedi patatha masiku angapo opaleshoniyo.Izi zili choncho chifukwa wodwalayo anayamba thrombosis yozama ya mitsempha pambuyo pa opaleshoni ndipo anamwalira chifukwa cha pulmonary embolism chifukwa cha thrombus yomwe inatuluka.Rivaroxaban, wavomerezedwa kuti agwiritsidwe ntchito kwa odwala akuluakulu omwe akuchitidwa opaleshoni ya chiuno kapena mawondo kuti ateteze venous thrombosis (VTE);ndi chithandizo cha 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 mathithi, omwe amatha 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 sikuli kocheperako kuposa warfarin, kuchuluka kwa magazi m'magazi a intracranial ndi otsika kuposa warfarin, ndipo kuwunika pafupipafupi kwamphamvu kwa anticoagulation sikofunikira, etc.
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 mopitirira muyeso, zochitika zazikulu zotuluka magazi, opaleshoni yadzidzidzi, kuchitika kwa thromboembolic zochitika kapena kuganiziridwa kuti simukutsata 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.