RESUMO
Atrial Fibrillation (AF) is the most common arrhythmia. AF is a major risk factor for stoke. Warfarin has been available for more than 60 years and until recently it was the only oral anticoagulant used for the prevention of stroke. Despite the extensive studies and proven efficacy, its utility is limited by multiple factors. Warfarin interacts with a multitude of drugs and foods, has a delayed onset of action, has a narrow therapeutic range, requires routine lab monitoring and exhibits variable responses in patients. The novel agents dabigatran, rivaroxaban and apixaban have the potential to have some of the limitations of warfarin. This article will discuss the pharmacokinetic and pharmacological considerations and different characteristics of the novel anticoagulants when used for the prevention of AF.
Assuntos
Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/farmacocinética , Anticoagulantes/farmacologia , Antitrombinas/farmacocinética , Antitrombinas/farmacologia , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/cirurgia , Fibrilação Atrial/terapia , Benzimidazóis/farmacocinética , Benzimidazóis/farmacologia , Inibidores do Fator Xa/farmacocinética , Inibidores do Fator Xa/farmacologia , Humanos , Morfolinas/farmacocinética , Morfolinas/farmacologia , Pirazóis/farmacocinética , Pirazóis/farmacologia , Piridonas/farmacocinética , Piridonas/farmacologia , Tiofenos/farmacocinética , Tiofenos/farmacologia , Varfarina/farmacocinética , Varfarina/farmacologia , beta-Alanina/farmacocinética , beta-Alanina/farmacologiaRESUMO
For more than 50 years, warfarin has single-handedly ruled the world of anti-coagulation without any competition, whatsoever! The anticoagulant was made available in 1940 and since then no other anti-coagulant has ever been able to match it in the clinical arena. But it looks like that the advances in the field of anti-coagulation, for the first time, have seriously started to erode its base. This review takes a look at rivaroxaban, a direct factor Xa inhibitor and one of the most foremost competitors of warfarin.