For patients with atrial fibrillation or are at risk for thrombosis for several years, a new class of compound that inhibits the blood coagulation effective: the direct oral anticoagulants, abbreviated DOAK. Whether, and for whom it makes sense, of proven therapies out switch, explained Professor Dr. Edelgard Lindhoff-Last, Frankfurt, in front of pharmacists in Schladming, Austria.
To include the new drug class of the active ingredients Apixaban, Dabigatran, Edoxaban and Rivaroxaban. Similar to the much-used preparations with Heparin or Phenprocoumon, you ensure that the blood clotting. To prevent life-threatening blood clots. This can, depending on where they occur in the body, a pulmonary embolism, or cause a stroke. Such clots occur most frequently in people with atrial fibrillation or people who have already had a thrombosis.
The DOAKs displace in the practice of everyday life, more and more of the former standards of therapy, Heparin, and Phenprocoumon. And not without reason, as Lindhoff-Last was. On the one hand, they act similar to a heparin syringe. On the other hand, they showed in studies for the various ingredients that you vorbeugten re-thrombosis of a similar level to Phenprocoumon. At the DOAKs of rare severe bleeding and especially bleeding in the brain occurred, however, during the treatment than after the intake of Phenprocoumon. They also lowered the risk of stroke in patients with atrial fibrillation. In return, the DOAKs increased, with the exception of Apixaban, the risk for bleeding in the gastro-intestinal tract. The reason for this is that these medicinal substances are present already after taking in the gastro-intestinal tract in an effective Form. This is not according to the expert, in the case of Phenprocoumon.
A further advantage of the DOAK is in the long-term therapy. These runs, depending on the thrombotic risk of relapse of the patient over many months or even permanently. Here, the doctor may reduce the dose of the DOAKs, after some time, which in turn reduces the risk of bleeding. For Phenprocoumon, the not going. It will always be used in the same dose, said the Doctor. The switch to DOAK makes the therapy for many patients, safer, and easier. He is not suitable for all, said Lindhoff-Last.
Just for patients with cancer diseases in the gastrointestinal or urogenital tract, the DOAKs increased the risk of bleeding, because they are not found only in the stomach and intestines, but also in the kidney and urine in the active Form. Here Phenprocoumon is still mostly used. Patients with special diseases of the heart such as heart valve problems continue to be addressed.
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