Pharmacology

Direct factor Xa inhibitors bind to the active site of factor Xa and block the interaction of factor Xa with its substrates (Hirsh et al., 2005). Unlike indirect factor Xa inhibitors which are catalytic and result in AT-mediated irreversible inhibition of free factor Xa, the direct factor Xa inhibitors are reversible, and not only inhibit free factor Xa, but also inactivate factor Xa bound to platelets within the prothrombinase complex (Table 5). This represents an important theoretical

TABLE 5 Comparison of Indirect and Direct Factor Xa Inhibitors

Characteristic

Indirect

Direct

Inhibitory mechanism

AT-dependent

AT-independent

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