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Pharmacology · single question

What is the mechanism of action of rivaroxaban (Xarelto)?

  1. Inhibits thrombin directly
  2. Direct inhibitor of Factor Xa
  3. Inhibits platelet aggregation
  4. Competitively inhibits vitamin K
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Correct answer: B. Direct inhibitor of Factor Xa

  • A. DIRECT THROMBIN INHIBITION is the mechanism of dabigatran (Pradaxa) — NOT rivaroxaban. Rivaroxaban inhibits Factor Xa; dabigatran inhibits thrombin (Factor IIa).
  • B. Rivaroxaban (Xarelto) is a DIRECT ORAL ANTICOAGULANT (DOAC) that DIRECTLY INHIBITS FACTOR Xa (activated Factor X). By blocking Factor Xa, rivaroxaban prevents the conversion of prothrombin to thrombin and the formation of fibrin clot. Key dental consideration: no routine monitoring required (unlike warfarin), and dental procedures can generally be performed without stopping rivaroxaban for minor procedures.
  • C. Platelet aggregation inhibition is the mechanism of aspirin and clopidogrel — not rivaroxaban, which affects the coagulation cascade.
  • D. Competitive inhibition of Vitamin K (blocking VKORC1) is the mechanism of WARFARIN — not rivaroxaban.

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