絞り込み

18385

広告

国内唯一高速炉実験施設「常陽」 運転再開時期の目標見直しへ (NHK)

国が実用化を目指す、プルトニウムを燃料にする高速炉の国内唯一の実験施設「常陽」の運用再開が、予定の2022年度末に間に合わず、目標を見直すことがわかりました。 ...

  1. [企業] ESMO20 Sanofi/R...
  2. [企業] 癌の血液検査会社GRAILを8...
  3. [企業] 新型コロナウイルスワクチンAZ...
  4. 新型コロナウイルスに関連した患者等の発生...

ニュース一覧

Management of Bleeding With Non-Vitamin K Antagonist Oral Anticoagulants in the Era of Specific Reversal Agents.

著者 Ruff CT , Giugliano RP , Antman EM
Circulation.2016 Jul 19 ; 134(3):248-61.
この記事をPubMed上で見るPubMedで表示
この記事をGoogle翻訳上で見る Google翻訳で開く

スターを付ける スターを付ける     (278view , 0users)
Vitamin K antagonists are commonly used by clinicians to provide anticoagulation to patients who have or are at risk of having thrombotic events. In addition to familiarity with the dosing and monitoring of vitamin K antagonists, clinicians are accustomed to using vitamin K if there is a need to reverse the anticoagulant effect of vitamin K antagonists. There are now 4 new non-vitamin K antagonist oral anticoagulants (NOACs) that are attractive alternatives to vitamin K antagonists. Despite similar or lower rates of serious bleeding with NOACs in comparison with warfarin, there is a pressing need for strategies to manage bleeding when it does occur with NOACs and to reverse the pharmacological effect of these agents if needed. Important steps in minimizing bleeding risks with NOACs include dose adjustment of the agents in the setting of renal dysfunction and avoidance of the concomitant use of other antithrombotic agents if feasible. Laboratory measurement of the anticoagulant effect of NOACs is best accomplished with specialized assays, although some of the more widely available coagulation tests can provide information that is potentially useful to clinicians. Nonspecific hemostatic agents such as prothrombin complex concentrates and recombinant factor VIIa can be used to reverse the effect of NOACs. More specific reversing agents include the approved humanized monoclonal antibody fragment idarucizumab for reversing the effects of dabigatran, the investigational factor Xa decoy andexanet alfa, and the synthetic small molecule ciraparantag. Both andexanet and ciraparantag have been reported to reverse the effects of the anti-Xa NOACs (rivaroxaban, apixaban, and edoxaban), and a number of other anticoagulant agents in common clinical use, as well.
PMID: 27436881 [PubMed - in process]
印刷用ページを開く Endnote用テキストダウンロード