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首页> 外文期刊>Current opinion in hematology >Novel thrombin and factor Xa inhibitors: Challenges to reversal of their anticoagulation effects
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Novel thrombin and factor Xa inhibitors: Challenges to reversal of their anticoagulation effects

机译：新型凝血酶和因子XA抑制剂：逆转抗凝作用的挑战

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PURPOSE OF REVIEW: Warfarin has been the sole oral anticoagulant used in the management of thromboembolic disorders for over 60 years. Target-specific oral anticoagulants (TSOAs) have recently emerged as alternatives to warfarin, because they do not require laboratory monitoring. Nevertheless, with the rising use of TSOAs, there is growing concern among clinicians regarding management of bleeding in patients taking them. Unlike warfarin, there is no antidote or reversal agent for TSOAs. This review summarizes recent developments and attempts to provide a systematic approach to patients on TSOAs presenting with bleeding complications. RECENT FINDINGS: Currently, data involving clinical management of TSOAs are limited and primarily based on ex-vivo or animal models using hemostatic agents with uncertain implications in bleeding patients. There is a pressing need for randomized clinical trials evaluating the safety and efficacy of hemostatic agents. SUMMARY: Without evidence-based guidelines for TSOA management, appropriate patient care requires an understanding of TSOA pharmacology, their effect on coagulation tests and, hence, a correct interpretation of test results, as well as a systematic approach to bleeding complications.
机译：审查目的：Warfarin一直是用于管理血栓栓塞障碍超过60年的唯一口服抗凝血剂。目标特异性口腔抗凝血剂（TSOA）最近被赋予华法林的替代品，因为它们不需要实验室监测。尽管如此，随着TSOA的使用不断上升，临床医生患有患者患者的临床医生越来越担心。与华法林不同，TSOA没有解毒剂或逆转剂。本综述总结了最近的发展和企图为患者提供患者的患者呈现出血并发症。最近的调查结果：目前，涉及TSOA的临床管理的数据是有限的，主要基于使用止血剂的前体内或动物模型，在出血患者中有不确定的影响。随机临床试验需要评估止血剂的安全性和功效的随机临床试验。摘要：没有基于循证的TSOA管理指南，适当的患者护理需要了解TSOA药理学，它们对凝血试验的影响，因此对测试结果的正确解释，以及渗出并发症的系统方法。

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