Abstract：
UNASSIGNED: Direct oral anticoagulants (DOACs) have overtaken vitamin K antagonists to become the most widely used method of anticoagulation for most indications. Their stable and predictable pharmacokinetics combined with relatively simple dosing, and the absence of routine monitoring has made them an attractive proposition for healthcare providers. Despite the benefits of DOACs as a class, important differences exist between individual DOAC drugs in respect of their pharmacokinetic and pharmacodynamic profiles with implications for dosing and reversal in cases of major bleeding.
UNASSIGNED: This review summarizes the state of knowledge relating to the pharmacokinetics of dabigatran (factor IIa/thrombin inhibitor) and apixaban, edoxaban and rivaroxaban (factor Xa) inhibitors. We focus on pharmacokinetic differences between the drugs which may have clinically significant implications.
UNASSIGNED: Patient-centered care necessitates a careful consideration of the pharmacokinetic and pharmacodynamic differences between DOACs, and how these relate to individual patient circumstances. Prescribers should be aware of the potential for pharmacokinetic drug interactions with DOACs which may influence prescribing decisions in patients with multiple comorbidities. In order to give an appropriate dose of DOAC drugs, accurate estimation of renal function using the Cockcroft-Gault formula using actual body weight is necessary. An increasing body of evidence supports the use of DOACs in patients who are obese, and this is becoming more routine in clinical practice.
UNASSIGNED: This review summarizes the state of knowledge relating to the pharmacokinetics of dabigatran (factor IIa/thrombin inhibitor) and apixaban, edoxaban and rivaroxaban (factor Xa) inhibitors. We focus on pharmacokinetic differences between the drugs which may have clinically significant implications.
UNASSIGNED: Patient-centered care necessitates a careful consideration of the pharmacokinetic and pharmacodynamic differences between DOACs, and how these relate to individual patient circumstances. Prescribers should be aware of the potential for pharmacokinetic drug interactions with DOACs which may influence prescribing decisions in patients with multiple comorbidities. In order to give an appropriate dose of DOAC drugs, accurate estimation of renal function using the Cockcroft-Gault formula using actual body weight is necessary. An increasing body of evidence supports the use of DOACs in patients who are obese, and this is becoming more routine in clinical practice.
摘要：
■直接口服抗凝剂（DOAC）已超过维生素K拮抗剂，成为大多数适应症使用最广泛的抗凝方法。其稳定和可预测的药代动力学与相对简单的剂量相结合，缺乏常规监测使它们成为医疗保健提供者的一个有吸引力的提议。尽管DOAC作为一类有好处，各个DOAC药物在药代动力学和药效学方面存在重要差异,这对大出血病例的给药和逆转具有重要意义.
■这篇综述总结了与达比加群（因子IIa/凝血酶抑制剂）和阿哌沙班的药代动力学有关的知识状况，依度沙班和利伐沙班（因子Xa）抑制剂。我们关注药物之间的药代动力学差异，这些差异可能具有临床意义。
■以患者为中心的护理需要仔细考虑DOAC之间的药代动力学和药效学差异，以及这些与个体患者情况的关系。处方者应该意识到与DOAC的药代动力学药物相互作用的潜力，这可能会影响患有多种合并症的患者的处方决策。为了给予适当剂量的DOAC药物，使用Cockcroft-Gault公式使用实际体重准确估计肾功能是必要的。越来越多的证据支持在肥胖患者中使用DOAC，这在临床实践中变得越来越常规。
■这篇综述总结了与达比加群（因子IIa/凝血酶抑制剂）和阿哌沙班的药代动力学有关的知识状况，依度沙班和利伐沙班（因子Xa）抑制剂。我们关注药物之间的药代动力学差异，这些差异可能具有临床意义。
■以患者为中心的护理需要仔细考虑DOAC之间的药代动力学和药效学差异，以及这些与个体患者情况的关系。处方者应该意识到与DOAC的药代动力学药物相互作用的潜力，这可能会影响患有多种合并症的患者的处方决策。为了给予适当剂量的DOAC药物，使用Cockcroft-Gault公式使用实际体重准确估计肾功能是必要的。越来越多的证据支持在肥胖患者中使用DOAC，这在临床实践中变得越来越常规。
