Apixaban is a relatively new drug prescribed to prevent thrombosis. It is used in patients who have undergone knee replacement surgery or hip replacement surgery. In this case, it is one of the preferred preparations because it can be administered in tablet form and is easier to dose than other preparations that also prevent blood clotting. In addition, the duration of action can be estimated relatively well.
What is apixaban?
Apixaban is a relatively new drug prescribed to prevent thrombosis. It is used in patients who have had knee replacement surgery or hip replacement surgery. The active ingredient apixaban belongs to the group of anticoagulants because it inhibits blood clotting. This is achieved by influencing the clotting factors in the blood plasma. The drug was developed in collaboration between the companies Bristol-Myers Squibb and Pfizer. Apixaban is a relatively new drug that was approved in the European Union in 2011 under the name Eliquis. Initially, approval was limited to the preventive avoidance of venous thromboembolism following musculoskeletal surgery. In Germany and Switzerland, it was initially used after knee replacement and hip operations. Further approvals, such as for the prevention of cerebral infarction and the treatment of deep vein thrombosis and pulmonary embolism, followed in December 2012 and July 2014.
Pharmacologic action
Unlike vitamin K antagonists, apixaban, which is taken twice daily in tablet form, is easier to dose. Once absorbed through the digestive tract, apixaban acts as a selective and inhibitor on the enzyme factor Ka. This enzyme, which is produced in the liver, belongs to the group of clotting factors. Factor Ka is responsible for the formation of thrombin from prothrombin. As a result, blood clotting cannot take place because fibrin can also no longer be formed from thrombin. The reason: thrombin is considered the most important enzyme for blood clotting in all vertebrates, including humans. Thrombin breaks down the glycoprotein fibrinogen into fibrinopeptides and fibrin. This is a protein that acts as a kind of glue during blood clotting. To do this, it forms a long-chain network that seals the wound. The effect of apixaban lasts between nine and 14 hours in the human body.
Medical application and use
In most cases, apixaban is administered to prevent thrombosis. This is a vascular disease in which blood clots can form in blood vessels. In this case, the blood clots can turn against the patient’s own body, so to speak. This is actually a protective mechanism that ensures that a wound can be closed quickly after injury. However, if the blood clot forms inside a closed blood vessel, this can lead to serious illnesses such as pulmonary embolism or stroke. In most cases, thromboses form in the veins of the cardiovascular system. Patients who have had hip or knee replacement surgery are particularly at risk. Because the undesirable consequences of thrombosis can lead to a life-threatening condition within a relatively short period of time, the administration of preparations such as apixaban is a better alternative for the patient.
Risks and side effects
Nausea is just one of several side effects that can occur with apixaban administration. Because blood clotting is inhibited by the drug, more severe bleeding can occur even with minor injuries. Furthermore, bruising forms relatively quickly, with blood escaping from the injured blood vessels and then being broken down via the body tissues. Patients may also develop anemia after apixaban administration. This term refers to anemia caused by a decrease in the concentration of hemoglobin in the blood. Hemoglobin is an oxygen-carrying protein found mainly in the red blood cells of the blood. Because this reduces the oxygen-carrying capacity of the blood, there is usually an increase in heart rate, which causes the blood to be pumped faster through the body.This, in turn, causes people to reach their performance limits more quickly than would normally be the case.
