Dab tsi yog qhov sib txawv hauv kev sib txawv thiab apixaban
Apixaban hmoov, cov tshuaj tiv thaiv kab mob siv los tiv thaiv cov ntshav txhaws, yog cov kev siv hluav taws xob siv ntau kauj ruam organcic presteremes. Nws cov synthesis cuam tshuam nws cov qauv molecular, uas suav nrog ntau pawg neeg tseem ceeb xws li cov lus qhia, benzene rings, thiab heterocyclic tib yam. Eliquis thiab nws yog qhov tseem ceeb tib yam. Eliquis yog tshuaj lub npe hom. Nws yog lub npe tseem ceeb, thiab nws tau siv kho kom zoo thiab tiv thaiv cov ntshav txhaws xws li cov leeg ntshav siab, dvt), thiab pulmonary embolism (pe). Yog tias koj txaus siab rau apixaban, thov koj xav tiv tauj Xi'an Sonwu.
Hauv ntej:
Eliquis: Hom npe
Apixaban: Lub npe generic
Ob lub npe xa mus rau tib cov tshuaj qub, nrog eliquis ua cov version uas muaj npe thiab nws ua cov khoom siv nquag. Qhov sib txawv tsuas yog nyob rau hauv tus nqi, muaj, thiab ntim, nyob ntawm seb koj puas siv lub npe lag luam lossis cov qauv ntawm cov khoom lag luam. Qhov ua tau zoo thiab kev nyab xeeb zoo ib yam rau ob qho tib si.
Vim li cas Apixaban tau zoo dua lwm cov doocs
Nws, ib qho ncauj ncaj qha Anticoculant (DAC), muaj ntau tus yam ntxwv uas ua rau nws rov piv rau lwm cov dacs, xws li Rivaroxaban, Dabigatran, thiab Edoxaban. Qhov zoo ntawm nws dhau lwm cov tshuaj tuaj yeem sau tau teev raws li hauv qab no:
1. Txo kev pheej hmoo ntawm cov ntshav loj
Nws tau pom tias muaj kev pheej hmoo qis dua ntawm cov ntshav loj piv rau qee cov neeg ua haujlwm, tshwj xeeb yog cov neeg uas muaj lub plab zom mov.
Nov yog qhov tau txais txiaj ntsig tseem ceeb, thaum muaj kev pheej hmoo los ntshav yog qhov kev txhawj xeeb loj thaum ua tshuaj tiv thaiv anticoagulants.
2. Muaj cov peev txheej kev nyab xeeb ntau dua
Nws txoj kev nyab xeeb profile yog sib piv cov kev pheej hmoo ntawm cov xwm txheej tsis zoo xws li cov ntshav tawm tsam piv rau qee yam anticoagulants.
Hauv kev sim tshuaj mob, nws pom tau tias muaj cov xwm txheej los ntshav thiab tsis zoo rau cov neeg mob siab dua los ntshav.
3. Tsawg dua cov ntsiab lus
Tsis zoo li Dabigatran thiab Rivaroxaban, nws yog tsawg dua ntawm renal clearance rau kev tshem tawm, ua nws cov kev xaiv zoo rau cov neeg mob uas muaj mob raum rau nruab nrab.
Qhov no txo qhov xav tau txhaj tshuaj kho kom haum rau cov neeg muaj lub raum loj, uas yog qhov tshwj xeeb tshaj rau cov neeg laus lossis cov muaj mob raum.
4. Muaj ntau txoj kev kwv yees pharmacokinetics
Nws tau twv tau tias pharmacinininetics nrog tsawg hloov pauv hauv kev coj cwj pwm hauv lub cev. Qhov no tau txais txiaj ntsig vim tias nws txo qhov xav tau ntawm kev soj ntsuam cov tshuaj khiav ntawm cov tshuaj sib xws, tsis zoo li Warfarin, thiab ua kom nws tswj tau yooj yim.
Qhov sib xws ntawm nws cov txiaj ntsig txhais tau tias tsis muaj kev pheej hmoo ntawm cov tshuaj underperforming lossis ua rau cov kev mob tshwm sim vim muaj kev sib txawv lossis cov metabolism.
5. Puam Dosing thiab yooj yim
Feem ntau tau noj ob zaug txhua hnub (BID Dosing), uas feem ntau piv rau qee qhov dosacs zoo li rivaroxaban, uas yog noj ib zaug txhua hnub.
Rau qee tus neeg mob, ob zaug cov kev tshuaj noj ob zaug txhua hnub yuav tau lees paub, txawm hais tias ib hnub noj tshuaj yuav ua tau yooj yim rau lwm tus.
6. Tsis muaj ib tug kev soj ntsuam uas xav tau
Zoo li lwm cov dacs, nws tsis tas yuav soj ntsuam kev ua haujlwm sib txawv xws li Inr (International Normalized Ornevelized tshaj Warfarin. Qhov no ua kom yooj yim kho thiab txhim kho tus neeg mob ua ntej.
Txawm li cas los xij, qee tus neeg mob muaj lub neej muaj zog heev lossis muaj lub neej muaj dua tseem xav tau ntau dua rau kev txhaj tshuaj.
7. Kev ua tau zoo nyob rau hauv kev sib txawv
Nws yog qhov ua tau zoo nyob rau hauv ntau qhov chaw kuaj mob, xws li kev tiv thaiv thiab kev kho mob ntawm cov leeg plab zom mov (PE), thiab kev tiv thaiv mob ntsws ntsws hauv atrial fibrillation. Nws tau pom tsis muaj qhov ua tau zoo dua los yog ua kom zoo dua hauv ntau qhov kev sim tshuaj xyuas, uas tau tsim nws cov khoom noj kom zoo ua rau anticoagulant.
8. Reversal Tus Neeg Sawv Cev Muaj
Thaum lub sijhawm no tsis yog qhov tshwj xeeb rau nws, nws tsim nyog sau cia tias ib tus neeg sawv cev rov qab los ntawm cov neeg mob rov qab) tau tsim los ntawm kev phais lossis thaum muaj kev phais mob sai. Thaum muaj xwm ceev, qhov no muaj kev ruaj ntseg ntxiv.
9. Kev siv tshuaj yeeb tshuaj
Muaj ntau lub caij nyoog tshuaj-yeeb tshuaj sib cuam tshuam nrog nws piv rau lwm cov dabigatran, uas muaj ntau cuam tshuam los ntawm inhibitors thiab qhov tseem ceeb ntawm p-glycoprotein. Qhov no tuaj yeem yooj yim sim kho, tshwj xeeb tshaj yog rau cov neeg mob ntawm polypharmacy.
Kev sib piv nrog lwm cov dacs:
Rivaroxaban: Thaum lub sijhawm Rivaroxaban kuj tseem ua tau zoo thiab siv tau ib zaug (ib zaug ib hnub), nws muaj qhov kev pheej hmoo siab ib zaug ntxiv piv rau nws. Nws tseem muaj kev ntseeg siab dua ntawm lub raum clearance, uas txhais tau tias nws yuav tsis haum rau cov neeg mob uas tsis muaj raum muaj nuj nqi.
Dabigatran: Dabigatran, ib tug ncaj qha thrombin inhibitor, tau txuas ntxiv rau cov kev hloov pauv ntawm lub raum muaj ntau dua hauv cov neeg mob raum. Ib qho ntxiv, Dabigatran yuav tsum muaj qib siab ntawm kev soj ntsuam hauv qee kis.
EDOXABAN: Edoxaban muaj cov kev tshuaj ib zaug ib zaug, tab sis nws yuav tsis muaj tib yam kev ua ntshav kom zoo dua qub, xws li lub cev hnyav lossis lub cev tseem ceeb ntawm lub cev.
Hauv kev xaus, nws yog qhov zoo dua li lwm cov doocs hauv qee thaj chaw vim nws qhov kev tiv thaiv qis dua, nrog rau cov ua haujlwm tsis taus ntawm lub cev thiab yooj yim. Txawm li cas los xij, qhov kev xaiv zoo tshaj plaws ntawm Anticoagulan siab kawg yog nyob ntawm tus neeg mob ib yam, suav nrog cov kev pheej hmoo ntawm lub raum, thiab siv yeeb tshuaj.
Qhov twg yog apixaban abraced
Lub plab zom mov (GI) nyiaj yuav nqus nws tom qab cov thawj coj ntawm qhov ncauj. Nws yog feem ntau nqus tau nyob rau hauv feem ntau txoj hnyuv, qhov uas nqus tau cov tshuaj tshwj xeeb tshaj plaws.
Ua raws li kev haus ntawm qhov ncauj, nws yog nrawm nrawm mus rau hauv cov hlab ntshav, nrog lub siab ntshav ntau zaus feem ntau tshwm sim tsis pub dhau 3 txog 4 teev tom qab kev tswj hwm. Cov tshuaj no yog li 50%, txhais tau tias kwv yees li ib nrab ntawm cov koob tshuaj mus txog ntawm cov kev ncig thiab hla dhau lub plab thiab lub siab.
Nws txoj kev nqus tuaj yeem cuam tshuam los ntawm cov zaub mov noj, tab sis nws tsis tas yuav tsum muaj zaub mov kom haum. Cov txheej txheem nqus tau feem ntau, tso cai apixaban kom tau siv nws cov teebmeem hauv kev ua kom ntshav nkag thiab txo qhov kev pheej hmoo ntawm cov ntshav txhaws.
Yog tias koj xav paub tus nqi ntawm Apixaban hmoov, xav tau lwm cov lus nug, lossis muaj lwm cov lus nug txog cov khoom, thov koj xav tiv tauj Xi'an Soniau.