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Medicinski časopis
2017, vol. 51, br. 3, str. 89-97
jezik rada: srpski
vrsta rada: pregledni članak
doi:10.5937/mckg51-15563


Direktni oralni antikoagulantni lekovi u profilaksi i terapiji tromboembolijskih bolesti
aKlinički centar Srbije, Beograd
bUniverzitet u Beogradu, Farmaceutski fakultet
cInstitut za kardiovaskularne bolesti 'Dedinje', Beograd + Medicinski fakultet, Univerzitet u Beogradu

e-adresa: aleksn@pharmacy.bg.ac.rs

Sažetak

Više od 50 godina, antagonisti vitamina K bili su jedini dostupni oralni antikoagulantni lekovi. S obzirom na to da njihova primena podrazumeva brojna ograničenja, bilo je neophodno razviti i uvesti u kliničku praksu nove oralne antikoagulantne lekove. Ovi lekovi imaju brojne prednosti u poređenju s antagonistima vitamina K, koje uključuju brz početak i prestanak dejstva, mali broj interakcija s drugim lekovima i hranom, pojednostavljen način doziranja, kao i predvidivu farmakokinetiku, čime se eliminiše potreba za svakodnevnim laboratorijskim praćenjem. Osim toga, novi oralni antikoagulantni lekovi deluju selektivno samo na jedan faktor koagulacije. Trenutno su odobreni za upotrebu direktni inhibitor trombina, dabigatran eteksilat, kao i direktni inhibitori faktora Xa, rivaroksaban, edoksaban i apiksaban. Dabigatran eteksilat i apiksaban odobreni su za primarnu prevenciju venske tromboembolije kod odraslih pacijenata koji se podvrgavaju elektivnom hirurškom zahvatu totalne zamene kuka ili kolena, dok je za prevenciju moždanog udara i sistemske embolije kod odraslih pacijenata sa nevalvularnom atrijalnom fibrilacijom, pored navedenih antikoagulantnih lekova, odobren i edoksaban. Za terapiju i prevenciju rekurentne duboke venske tromboze odobreni su dabigatran eteksilat, rivaroksaban i edoksaban. Osim toga, rivaroksaban je odobren i za sekundarnu prevenciju aterotrombotičkih događaja nakon akutnog koronarnog sindroma.

Ključne reči

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