Anti factor Xa

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Direct Anti factor x:

D r mohammed abdelsattar D irect Anti factor x

anticoagulants of Factor Xa:

anticoagulants of Factor Xa Ind irect Xa inhibitor Direct Xa inhibitor

Indirect Xa inhibitor:

Indirect Xa inhibitor I ndirect :_ Injected form as Unfractionated heparin , low molecular weight heparin (LMWH), and fondaparinux inhibit the activity of factor Xa indirectly by binding to circulating antithrombin (AT III ). O ral form as Warfarin active vitamin K antagonists (VKA) which decrease hepatic synthesis of a number of coagulation factors, including Factor X.

Indirect Xa inhibitor:

Indirect Xa inhibitor several characteristics that complicate their use in routine clinical practice : slow onset of action, a narrow therapeutic index , numerous dietary and drug interactions , a variable anticoagulation response a requirement for frequent anticoagulation monitoring.

Direct Xa inhibitor:

Direct Xa inhibitor class of anticoagulant drugs which act directly upon Factor X in the coagulation cascade

Direct Xa inhibitor:

Direct Xa inhibitor several characteristics that encourage their use in routine clinical practice: rapid onset of action no dose adjustment is necessary for age alone, sex, or body weight administration at fixed doses no requirement for routine coagulation monitoring

Direct Xa inhibitor:

Direct Xa inhibitor Rivaroxaban ( Xarelto ) Apixaban ( Eliquis ) Edoxaban ( Lixiana )

Rivaroxaban:

Rivaroxaban orally active direct factor Xa inhibitor Brand Name: Xarelto rapidly excreted via renal and fecal/biliary routes The effects last approximately 8–12 hours, but factor Xa activity does not return to normal within 24 hours so once-daily dosing is possible . Inhibition of Factor Xa interrupts the intrinsic and extrinsic pathway of the blood coagulation cascade, inhibiting both thrombin formation and development of thrombi

Rivaroxaban:

Rivaroxaban for stroke prevention in non- valvular atrial fibrillation 20 mg/day PO DVT Prophylaxis (Orthopedic Surgery ) 10 mg PO qDay DVT or PE Treatment 15 mg PO q12hr for 21 days with food, THEN 20 mg PO qDay for 6 months

Rivaroxaban:

Rivaroxaban SWITCHING TO AND FROM RIVAROXABAN : Discontinue warfarin and start rivaroxaban as soon as the INR is below 3 Renal Dose Adjustments CrCl 29 mL/min or less : Avoid use Liver Dose Adjustments Moderate to severe liver dysfunction (Child-Pugh B and C) or hepatic disease associated with coagulopathy: Avoid use

Rivaroxaban:

Rivaroxaban The effect of rivaroxaban on PT is short-lived (e.g. minimal effect at 24 hours post-dosing )

Apixaban :

Apixaban oral drug Brand Name: Eliquis an anticoagulant that works by blocking the action of factor Xa . used for preventing blood clots in patients with atrial fibrillation . It is also used to prevent blood clots in people who have had a hip or knee replaced .

Apixaban :

Apixaban Usual Adult Dose for Deep Vein Thrombosis Prophylaxis after Knee Replacement Surgery 2.5 mg orally 2 times a day Usual Adult Dose for Prevention of Thromboembolism in Atrial Fibrillation and Thromboembolic Stroke Prophylaxis 5 mg orally 2 times a day Usual Adult Dose for Deep Vein Thrombosis and Pulmonary Embolism Initial dose: 10 mg orally 2 times a day for 7 days Maintenance dose: 5 mg orally 2 times a day

Apixaban :

Apixaban -Reduce dose to 2.5 mg orally 2 times a day for patients with any 2 of the following: --Age 80 years or older --Body weight 60 kg or less --Serum creatinine 1.5 mg/ dL or higher Liver Dose Adjustments Severe liver impairment (Child-Pugh C): Not recommended

Edoxaban:

Edoxaban selective factor Xa inhibitor Edoxaban quickly reaches peak plasma concentrations in 1.5 h, has a half-life of 10–14 h thromboprophylaxis after total hip replacement stroke prevention in patients with atrial fibrillation approved in July 2011 in Japan for prevention of venous thromboembolisms (VTE) following lower-limb orthopedic surgery

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http://emedicine.medscape.com/article/209867-overview http://www.medscape.com/viewarticle/456874_3 http ://en.wikipedia.org/wiki/Direct_Xa_inhibitor http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546633/

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