rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2018-14-6-944-950rpcardio-1812Research ArticleCURRENT QUESTIONS OF CLINICAL PHARMACOLOGYАКТУАЛЬНЫЕ ВОПРОСЫ КЛИНИЧЕСКОЙ ФАРМАКОЛОГИИSpecific Antidotes for Direct Oral Anticoagulants in Life-Threatening BleedingСпецифические антидоты для прямых оральных антикоагулянтов при угрожающих жизни кровотеченияхСумароковА. Б.SumarokovA. B.

к.м.н., с.н.с., Научно-исследовательский институт клинической кардиологии им А.Л. Мясникова

MD, PhD, Senior Researcher, Research Institute of Clinical Cardiology n.a. A. L. Myasnikov

vokoramus@mail.ruБурячковскаяЛ. И.BuryachkovskayaL. I.

д.м.н., в.н.с., Институт Экспериментальной кардиологии

MD, PhD, Leading Researcher, Institute of Experimental Cardiology

ЛомакинН. В.LomakinN. V.

к.м.н., руководитель отделения кардиореаниматологии

MD, PhD, Head of Cardioreanimatology Department

Национальный медицинский исследовательский центр кардиологииРоссияNational Medical Research Centre of CardiologyRussian FederationЦентральная клиническая больница с поликлиникой Управления Делами Президента РФРоссияCentral Clinical Hospital of the Presidential Administration of the Russian FederationRussian Federation201805012019146944950Copyright © Sumarokov A.B., Buryachkovskaya L.I., Lomakin N.V., 20192019Сумароков А.Б., Бурячковская Л.И., Ломакин Н.В.Sumarokov A.B., Buryachkovskaya L.I., Lomakin N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/1812

Review presents data on medicines from the new group of cardiovascular drugs, direct oral anticoagulants (DOACs) inhibitors, as antidotes for DOAC when stopping life-threatening bleeding. DOAC therapy is accorded by hemorrhages with lower frequency than therapy by indirect anticoagulants, but really exist. New antidotes for DOACs are idarucizumab, andexanet, ciraparantag. The need in antidotes for DOAC may suddenly appear in spontaneous bleeding, during surgical operation, invasive procedure, due to trauma, in patients with stroke, kidney or liver failure. Data is given on the frequency of the main types of bleeding while taking new oral anticoagulants. Information concerning use of antidotes for DOACs in bleedings as well as use of non-specific therapy are reviewed.

 

В статье собраны сведения о лекарственных средствах из новой группы сердечно-сосудистых препаратов – ингибиторах действия прямых оральных антикоагулянтов (ПОАК), которые могут быть использованы в качестве антидота при остановке угрожающих жизни кровотечений у больных, получавших ПОАК. Прием ПОАК сопровождается несколько меньшей частотой больших кровотечений, чем при терапии непря- мыми антикоагулянтами, но их применение также несет риск геморрагий, представляющих угрозу жизни больного. Для борьбы с крово- течениями созданы новые лекарственные средства – антидоты ПОАК – идаруцизумаб, андексанет, цирапарантаг, потребность в которых может появиться при спонтанном кровотечении, кровотечениях, возникших при проведении экстренного хирургического или инвазивного вмешательства, при травме, инсульте, у больных с почечной или печеночной недостаточностью. Приведены сведения о частоте основных видов кровотечений на фоне приема новых оральных антикоагулянтов. Рассмотрены имеющиеся в зарубежной литературе сведения о при- менении специфических антидотов ПОАК при кровотечении и неспецифические методы лечения.

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The authors declare that there are no conflicts of interest present.