medicina61巻10号

2024年09月発行

特集 内科医が知っておくべきICU・ERでの薬の使い方 血液

止血製剤

著者： 山元良¹

所属機関： ¹慶應義塾大学医学部救急医学

ページ範囲：P.1692 - P.1695

Point
◎プロトロンビン複合体はビタミンK拮抗薬の抗凝固作用を抑制する目的として使用され，少ない容量負荷で迅速な効果発現が可能である．
◎プロトロンビン複合体はワルファリン服用中の急性重篤出血あるいは緊急手術・処置を行う際に保険適用となるが，容量負荷を避けたい患者や迅速な凝固能の回復が望ましい場面に良い適応となる．
◎イダルシズマブとアンデキサネット アルファは直接経口抗凝固薬（DOAC）の拮抗薬であるが，イダルシズマブはダビガトランのみ，アンデキサネット アルファはリバーロキサバン，アピキサバン，エドキサバンに対して有効である．
◎トラネキサム酸は外傷患者や周術期での効果が示されてきた止血薬剤であるが，消化管出血などの内科領域の出血性疾患ではその効果は確立していない．

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