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相关概念视频

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

1.2K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
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Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

763
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
763
Drug Distribution: Volume of Distribution01:25

Drug Distribution: Volume of Distribution

5.2K
The volume of distribution refers to the theoretical volume necessary to contain the entire amount of an administered drug at the same concentration observed in the blood plasma. The body's intracellular fluid compartment, which makes up two-thirds of the total body water, is contrasted with the extracellular fluid compartment—comprising plasma and interstitial fluid—that accounts for one-third. The volume of distribution can vary depending on the characteristics of the drug.
5.2K
Volume of Distribution01:20

Volume of Distribution

247
The apparent volume of distribution (Vd) is a crucial pharmacokinetic parameter representing the hypothetical body fluid volume into which a drug disperses. It is calculated based on the total amount of drug in the body (estimated from the administered dose and bioavailability) divided by the plasma drug concentration. The total amount of drug in the body does not directly refer to the dose given but is derived by accounting for absorption, distribution, metabolism, and excretion processes.
247
Drug Binding to Blood Components01:30

Drug Binding to Blood Components

175
When drugs enter systemic circulation, they interact with various components of the blood, including proteins such as human serum albumin (HSA), α1-acid glycoprotein (AAG), lipoproteins, globulins, and red blood cells (RBCs).
HSA is the most abundant plasma protein and is vital in drug binding. It contains distinct drug-binding sites, with different drugs exhibiting affinity for specific sites. There are three main drug-binding domains for HSA: sites I, II, and III. These domains are...
175
Factors Affecting Drug Distribution: Physiological Barriers01:23

Factors Affecting Drug Distribution: Physiological Barriers

254
Drug distribution in the body is intricately regulated by various physiological barriers that control the passage of substances. These include the capillary endothelial barrier, the blood-brain, blood-cerebrospinal fluid, blood-placental, and blood-testis barriers.
The capillary endothelial barrier allows only smaller molecules below 600 Da (Daltons) to pass through. It also restricts drugs like heparin that are bound to blood components, limiting their movement within the bloodstream.
The...
254

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相关实验视频

Updated: Jul 23, 2025

Tail Vein Transection Bleeding Model in Fully Anesthetized Hemophilia A Mice
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Tail Vein Transection Bleeding Model in Fully Anesthetized Hemophilia A Mice

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在DOAC水平的性别相关变化.

Anja Moldenhauer, Peter Hellstern, Till Hoffmann

    Clinical laboratory
    |July 12, 2023
    PubMed
    概括

    直接口服抗凝剂 (DOAC) 的峰值水平因年龄和性别而有很大差异,尤其是利瓦洛克萨班. 将年龄和性别纳入DOAC参考范围可能会提高这些抗凝剂患者的剂量准确性.

    科学领域:

    • 药理学 药理学是指药理学的学科.
    • 临床医学 临床医学
    • 血液学 血液学 血液学

    背景情况:

    • 直接口服抗凝剂 (DOAC) 如利瓦罗克萨班和阿皮克萨班越来越多地用于静脉血栓塞栓症 (VTE) 预防和治疗,经常取代维生素K对抗剂.
    • 准确的DOAC血水平测量对于特定临床场景中的剂量调整至关重要.
    • 峰值和低谷DOAC水平的显著个体间波动使治疗决策复杂化,原因是重叠的参考范围.

    研究的目的:

    • 通过考虑患者的年龄和性别,研究是否可以更精确地定义高峰和低谷DOAC血水平.
    • 为了确定年龄和性别是否影响里瓦洛克萨班和阿皮克萨班度.

    主要方法:

    • 从接受里瓦洛克萨班 (n=93) 或阿皮克萨班 (n=51) 治疗的患者中收集的抗Xa度的峰值和底值.
    • 分析了83个里瓦罗克萨班和49个阿皮克萨班样本,排除了那些不确定口服摄入的样本.
    • 在男性和女性之间以及在60岁以下和60岁以上的患者之间比较度,使用Student的t-test和回归分析.

    主要成果:

    • 对于阿皮克萨班的峰值水平,没有观察到显著的年龄或性别差异.
    • 与男性相比,女性的里瓦洛克萨班峰值度明显高 (308.8对206.4 ng/mL,p=0.013).

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  • 60岁以上的患者比年轻患者的峰值里瓦洛克萨班水平显著更高 (293.7比211.7ng/mL,p=1.29 x 10−8).

    • 结论:

    • 发现了与年龄相关的利瓦洛克萨班峰值水平的显著差异,这表明年龄应该影响参考范围.
    • 观察到与性别相关的里瓦罗克萨班水平差异,这可能解释了相关的高月经症.
    • 建议将年龄和性别纳入DOACs的血中峰值度参考值的确定.