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Apixaban is a highly selective, orally bioavailable, and reversible direct inhibitor of free and clot-bound factor Xa. Factor Xa catalyzes the conversion of prothrombin to thrombin, the final enzyme in the coagulation cascade that is responsible for fibrin clot formation. [ 27 ]
The monitoring of warfarin and keeping the international normalized ratio (INR) between 2.0 and 3.0, along with avoiding over and under treatment, has driven a search for an alternative. [ 3 ] [ 14 ] A naturally occurring inhibitor of factor Xa was reported in 1971 by Spellman et al. from the dog hookworm. [ 15 ]
The LD 50 for warfarin is 50–100 mg/kg for a single dose, after 5–7 days. [109] LD 50 1 mg/kg for repeated daily doses for 5 days, after 5–8 days. [109] The IDLH value is 100 mg/m 3 (warfarin; various species). [111] Resistance to warfarin as a poison has developed in many rat populations due to an autosomal dominant on chromosome 1 in ...
Apart from using unfractionated heparin instead, it may be possible to reduce the dose and/or monitor the anti-Xa activity to guide treatment. [ 3 ] The most common side effects include bleeding, which could be severe or even fatal, allergic reactions, injection site reactions, and increases in liver enzyme tests, usually without symptoms. [ 13 ]
Rivaroxaban, sold under the brand name Xarelto among others, is an anticoagulant medication (blood thinner) used to treat and prevent blood clots. [8] Specifically it is used to treat deep vein thrombosis and pulmonary emboli and prevent blood clots in atrial fibrillation and following hip or knee surgery. [8]
Clark's rule is a medical term referring to a mathematical formula used to calculate the proper dosage of medicine for children aged 2–17 based on the weight of the patient and the appropriate adult dose. [1] The formula was named after Cecil Belfield Clarke (1894–1970), a Barbadian physician who practiced throughout the UK, the West Indies ...
[2] [3] They emphasize deprescribing medications that are unnecessary, which helps to reduce the problems of polypharmacy, drug interactions, and adverse drug reactions, thereby improving the risk–benefit ratio of medication regimens in at-risk people. [4] The criteria are used in geriatrics clinical care to monitor and improve the quality of ...
Knowing the indication of the drug can also help providers determine if the dose of the drug is appropriate per indication, and this can greatly improve patient safety and drug effectiveness. [28] However, there are still some challenges with incorporating the indication of use on prescription drug labels.