CLINICAL ENCOUNTERS
ANTICOAGULATION
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Question
[CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
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It will remove Ca2+ through chelation.
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It will forms a complex with antithrombin III, catalyzing the inhibition of thrombin.
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It will removes calcium from coagulation system by precipitating it into unusable form.
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It will add calcium ion in blood preventing clotting.
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Detailed explanation-1: -Citrate is a weak base and so reacts with hydrochloric acid in the stomach to raise the pH. It it further metabolized to bicarbonate which then acts as a systemic alkalizing agent, raising the pH of the blood and urine 8. It also acts as a diuretic and increases the urinary excretion of calcium.
Detailed explanation-2: -(b) Sodium citrate begins to depress prothrombin activity at a concentration at which ionized calcium is still present. The inability of tricalcium phosphate to adsorb prothrombin from citrated plasma indicates that citrate forms a complex with prothrombin and it is postulated that prothrombin is thereby inactivated.
Detailed explanation-3: -Citrate inhibits the coagulation cascade by lowering the ionized calcium (iCa) concentration through the chelation of calcium in the filter. A proportion of the calcium citrate complexes is removed via the filter and the remainder enters the systemic circulation where citrate is rapidly metabolized.
Detailed explanation-4: -Fluoride inhibits glycolysis, and oxalate prevents clotting by precipitating calcium.