Dabigatran and rivaroxaban, new oral anticoagulants. New approaches in Dentistry
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Gómez Moreno, Gerardo; Aguilar Salvatierra, Antonio; Martin-Piedra, M.A.; Guardia Muñoz, Javier; Calvo Guirado, José Luis; Cabrera Ayala, Maribel; López Gallardo, Cristina; Castillo Naveros, Tania
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Aquest document és un/a article, creat/da en: 2010
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Treatment in patients with atrial fibrillation or venous thromboembolism in recent decades has been based almost
exclusively on the use of vitamin K antagonists. These drugs have a narrow therapeutic index, so it is precise to
repeated adjustments of doses that require analytical monitoring. For many years it has advocated the need to have
more convenient new antithrombotic drugs. So is developing a new generation of antithrombotic not related to
coumarin. In 2008 and 2009, two of these new anticoagulants have been registered and approved in Europe and Ca-
nada-these are dabigatran etexilate (Pradaxa ®) and rivaroxaban (Xarelto ®). Anticoagulant dabigatran is the first
direct thrombin inhibitor, orally available. Specifically and reversibly inhibits thrombin, so the duration of action
is predictable. The anticoagulant effect correlates well with plasma drug concentrations, which implies an effective
anticoagulation with low bleeding risk without major problems of interactions with other drugs. Rivaroxaban is first
oral anticoagulant inhibitor of factor Xa (FXa). It produces a predictable and reversible inhibition of FXa activity
with ability to inhibit clot-bound FXa. The predictable pharmacokinetics and pharmacodynamics characteristics
of dabigatran and rivaroxaban may facilitate dental management of patients who until now have been in treatment
with traditional anticoagulants, given that it doesn’t require routine laboratory monitoring in the vast majority of
patients treated. They also present a profile of drug interactions very favourable.
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