Management Evidence for NOAC in Stroke Prevention in Non-Valvular Atrial Fibrillation Characteristics of non-vitamin K antagonist oral anticoagulants (NOACs) They have variable half-lives that are highly dependent on renal and/or liver function. They also have a rapid onset of action, reaching peak plasma concentrations in less than 3 – 4 hours. The major practical advantage of the NOACs over warfarin is their predictable pharmacokinetic and pharmacodynamic properties (relative to warfarin), which allow these drugs to be given once or twice daily by mouth in fixed doses. 3, 4 Table 1 summarizes the important properties of NOACs relevant to clinicians. NOACs share similar clinical characteristics but they each have unique pharmacological profiles that determine their safety and suitability in individual patients. Characteristics and Pharmacological Properties 2 In contrast, the traditional anticoagulants, namely heparin, low molecular weight heparin and warfarin, are indirect inhibitors that block multiple coagulation factors. By inhibiting the action of these key enzymes in the coagulation cascade, these drugs have potent anticoagulant properties. 1 The NOACs currently available in Canada (i.e., dabigatran, rivaroxaban, apixaban) are designed to target thrombin (direct thrombin inhibitors) or activated factor X (FXa). Non-vitamin K antagonist oral anticoagulants (NOACs) are a class of drugs that directly inhibits the activity of specific “targeted” coagulation factors. Non-valvular atrial fibrillation (AF) is defined as AF that occurs in absence of rheumatic mitral stenosis, a mechanical or bioprosthetic heart valve, or mitral valve repair.
0 kommentar(er)
