Deep vein thrombosis can be described as the formation of a blood clot within a deep vein especially those located in the lower limb regions of the legs. The condition may manifest with some non-specific signs, for example, a feeling of warmth at the affected area, some pain; the region may also appear red in most instances together with the surface veins being engorged. This research is aimed at determining the possible causes of deep vein thrombosis and the drugs used in its treatment. This paper explains in detail the causes of deep vein thrombosis, its symptoms and the drugs used in its treatment. The main being on Xarelto and further elaborates mode of action of this drug and its mechanism of action, some of the resulting side effects of using this drug, and other drugs which can also be utilized in the treatment of deep vein thrombosis.
Research development
Deep vein thrombosis is among the common disorders with increased mortality rates if not properly managed. The condition may be clinically induced by trauma, prolonged bed rest, and surgical operations. Several studies have shown that low-dose anticoagulation therapies are effective in the management of the deep vein thrombosis. Research has shown that approximately 25% of patients have significant thrombus. Studies have shown that men are more at risk of thrombosis conditions than women (Einstein, 2012). The initial anticoagulant treatment like heparin may be used intravenously or subcutaneously followed by oral anticoagulant treatment. Studies show that various anticoagulants may be active in the management. There is no research evidence for the duration of anticoagulant use against deep vein thrombosis. Some research has shown that rivaroxaban which is a factor Xa inhibitor may be utilized effectively. Xarelto is a factor Xa inhibitor and can be used in the management of deep vein thrombosis. However, only a few papers have been written on the use of Xarelto in the strategic management of deep thrombosis hence the need for research (Fawole, Daw, & Crowther, 2013).
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Causes of deep vein thrombosis
Many factors can predispose an individual to deep vein thrombosis. The changes in the endothelial blood vessels together with the factors of Virchow’s triad including hypercoagulability and venous stasis can make a person to develop this condition. There are also other conditions which may predispose an individual to develop the condition. Some of the risk factors may be acquired due to old age a period during which the composition of blood during that age highly favors clotting of blood. An individual can also develop the condition during a surgical procedure or trauma during which tissue factor from outside the blood vessels may enter the blood circulation and thus in the process of blood circulation they may cause the condition.
Pathophysiology of deep vein thrombosis
It has been shown that deep vein thrombosis develops in the direction of venous flow towards the heart and majorly on the calf veins. In instances when it does not grow it be cleared on its own and be dissolved in blood under natural conditions. The veins located in the thigh region are the primarily affected ones including the femoral vein which is essential in blood circulation. It can be diagnosed by imaging techniques which aim to locate the position of the clot which later be removed through surgical means (Kyrle & Eichinger, 2005).
Treatment
The purpose of treating of this condition is to minimize the chances of the clot to increase in size while on the other hand prevent it from breaking which may cause embolism and finally lessen the likelihood of its reoccurrence. It has several treatment options among them the use of blood thinners which are majorly anticoagulants which minimize blood clotting. After treatment is started by an injection of heparin, it may be followed by injections of other blood thinners for example dalteparin, enoxaparin and fondaparinux. Treatment can also be given pill form, for instance, the Warfarin or rivaroxaban knew as Xarelto. For the purpose of this paper, I would focus on Xarelto.
Action of Xarelto in treatment of deep vein thrombosis
Rivaroxaban tends to inhibit the two factors which are bound on in the prothrombinase complex one of these factors being Factor Xa. This drug is a highly selective due to its oral bioavailability and its immediate mode of action. The blood coagulation cascade which controls clotting is usually interrupted by the inhibition of Factor Xa which affects the intrinsic and the extrinsic factors. This drug has no effect on thrombin neither has any effect been demonstrated on platelets.
Rivaroxaban may have adverse side effects which can worsen the condition already at hand. It may cause severe bleeding with the gastrointestinal tract the most affected (Einstein, 2012). As compared to Warfarin it can cause fatal and more severe bleeding. The bleeding which results does has not received any solution meaning it may be difficult to manage. A prior assessment carried on this drug before being released to the market had shown its adverse effects on the liver though this has not been quantified. Discontinuing the use of this medication may make its users more prone to stroke, and thus users are advised not to leave it before consulting with their physicians.
Deep vein thrombosis is a disorder that may claim lives if not well managed in both symptomatic and asymptomatic patients. Various anticoagulants including heparin have been used to control deep vein thrombosis. This research paper would seek to explore the possible use of Xarelto in deep venous thrombosis treatment since it is a factor Xa inhibitor. Based on the mechanisms of action with limited side effects, there is the need for studies to develop and enhance the use of Xarelto as an effective treatment for the condition.
References
Einstein P.E Investigators. (2012). Oral rivaroxaban for a treatment of symptomatic pulmonary embolism. N Engl j Med, 2012(366), 1287-1297.
Kyrle, P. A., &Eichinger, S. (2005). Deep vein thrombosis. The Lancet, 365(9465), 1163-1174.
Fawole, A., Daw, H. A., &Crowther, M. A. (2013). Practical management of bleeding due to the anticoagulants dabigatran, rivaroxaban, and apixaban. Cleveland Clinic Journal of Medicine, 80(7), 443-451.
