在直接口服抗凝剂逆转中的前素复合度:一个系统的范围审查
Nazedah Ain Ibrahim1, Jiaa Yinn Tang2, Hayati Alwani Yahaya2
1Department of Pharmacy, Hospital Tunku Azizah, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia.
The Journal of emergency medicine
|July 4, 2025
概括
当特定的药物无法使用时,前素复合物缩剂 (PCC) 可以逆转直接口服抗凝剂 (DOAC). 本审查审查了马来西亚DOAC逆转的PCC有效性和安全性.
科学领域:
- 药理学 药理学是指药理学的学科.
- 血液学 血液学 血液学
- 临床医学 临床医学
背景情况:
- 直接口服抗凝剂 (DOAC) 是华法林抗凝剂的替代品.
- 马来西亚缺乏广泛使用特定的DOAC逆转剂,如idarucizumab和 andexanet alfa.
- 在没有特定的药物的情况下,建议在危及生命的DOAC出血中使用前素复合缩剂 (PCC).
研究的目的:
- 评估PCC在逆转DOAC中的有效性和安全性.
- 为马来西亚目前使用PCC用于DOAC逆转提供见解.
主要方法:
- 使用PubMed,Wiley,Sage和谷歌学者进行了从2016年到2020年的研究范围审查.
- 包括PCC用于DOAC逆转的临床研究,遵循PRISMA扩展范围审查.
- 在马来西亚国家医学研究登记处注册的研究.
主要成果:
- 20项研究符合纳入标准,所有这些研究都描述了PCC用于DOAC逆转的使用 (剂量为25-50U/kg).
- 在15项研究中报告了静血效果,通常使用国际血栓与静血学会 (ISTH) 标准.
- 所有20项研究都评估了PCC的安全性,包括血栓事件和死亡风险.
结论:
- 需要进行高质量的研究,以进一步了解PCC对血液静止的有效性和安全性.
- 当特定的药物无法使用或DOAC类型不明时,PCC可以作为DOAC逆转的可行选择.
相关概念视频
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.3K
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...
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...
1.3K
Venous Thrombosis III: Interprofessional Care
26
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
26
Anticoagulant Drugs: Low-Molecular-Weight Heparins
919
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...
919
EDTA: Auxiliary Complexing Reagents
675
EDTA titrations are usually carried out in highly basic conditions, where the fully deprotonated form of EDTA, Y4−, actively complexes with the free metal ions in the solution. Several metal ions precipitate as hydrous oxide (hydroxides, oxides, or oxyhydroxides) under these conditions, lowering the concentration of free metal ions in the solution. For this reason, auxiliary complexing agents or ligands such as ammonia, tartrate, citrate, or triethanolamine are used in EDTA titrations to...
675
Coagulation
7.4K
The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
7.4K
Clot Retraction and Fibrinolysis
6.9K
After a fibrin clot is formed, the next step is clot retraction, a vital process facilitated by platelet contractile proteins, such as actin and myosin. These proteins pull the fibrin strands closer together and condense the clot. This action reduces the size of the clot, creating a smaller, denser structure that effectively seals off the damaged vessel. Clot retraction consolidates the clot and helps with wound healing by bringing the edges of the damaged blood vessel closer together.
6.9K


