sodium citrate

Action and Spectrum

Actions and spectrum: 

• Anticoagulant Action: sodium citrate acts as an anticoagulant by binding with calcium ions in the blood, preventing the coagulation cascade and clot formation. This property makes it useful in various medical procedures where the prevention of blood clotting is essential. 
• Blood Sample Collection: In medicine, sodium citrate is commonly used as anticoagulant in blood collection tubes. It helps maintain the integrity of blood samples by preventing clot formation, allowing for accurate laboratory analyses of blood components such as plasma. 
• Coagulation Studies: sodium citrate is frequently used in coagulation studies and tests, including prothrombin time (PT), and activated partial thromboplastin time (APTT). These tests assess the time it takes for blood to clot and are essential for evaluating the coagulation system. 
• Platelet Function Studies: sodium citrate is used to assess platelet function in laboratory studies. By inhibiting clot formation, it allows researchers to study platelet activity independently of the coagulation cascade. 

The spectrum of sodium citrate’s use is primarily within the realm of anticoagulation and blood sample preservation. Its application in laboratory and clinical settings is vital for accurate diagnostic testing and research. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Hypernoia 

Diarrhea 

Nausea & vomiting 

Convulsions 

Hypernatremia 

Looseness of bowel 

Metabolic alkalosis 

Black Box Warning

Black Box Warning: 

There is no specific black box warning associated with the use of sodium citrate. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Hypersensitivity or Allergy: Individuals with a known hypersensitivity or allergy to sodium citrate or its components should avoid its use. 
• Metabolic Alkalosis: sodium citrate can contribute to an increase in blood pH. It should be used with caution or avoided in individuals with conditions predisposing them to metabolic alkalosis. 
• Hypernatremia: sodium citrate contains sodium, and its use may exacerbate hypernatremia (elevated levels of sodium in the blood). Caution is advised in individuals with existing hypernatremia. 
• Heart Failure and Edema: sodium citrate’s sodium content may contribute to fluid retention. Individuals with heart failure or edema may need cautious use. 

Caution: 

• Renal Impairment: In individuals with renal impairment, particularly severe cases, there may be a risk of citrate accumulation. Dosage adjustments or alternative anticoagulants may be considered. 
• Fluid Retention: sodium citrate’s sodium content may contribute to fluid retention. Caution is advised in individuals with conditions such as heart failure or edema. 
• Pediatric and Geriatric Populations: Special caution may be needed when using sodium citrate in pediatric or geriatric populations, as they may be more vulnerable to electrolyte imbalances. 
• Monitoring: Close monitoring of electrolyte levels, especially sodium and potassium, is important when using sodium citrate, particularly in individuals with pre-existing conditions that may affect electrolyte balance.

Comorbidities: 

• Electrolyte Imbalances: sodium citrate contains sodium, and its use may contribute to electrolyte imbalances. Individuals with existing electrolyte imbalances or conditions affecting sodium balance may require careful monitoring. 
• Fluid Retention Conditions: sodium citrate’s sodium content may contribute to fluid retention. Caution is advised in individuals with conditions such as heart failure, edema, or other fluid retention disorders. 
• Dehydration: sodium citrate may exacerbate electrolyte imbalances in individuals with dehydration. Caution is recommended in such cases. 

Pregnancy / Lactation

Pregnancy consideration: pregnancy category: not assigned 

Lactation: excreted into human milk: unknown  

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 
• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

The pharmacology of sodium citrate is primarily related to its role as an anticoagulant, commonly used in medical and laboratory settings. As a salt of citric acid, sodium citrate acts by binding with calcium ions in the blood, preventing the coagulation cascade and subsequent blood clot formation.

This anticoagulant property makes it valuable in various clinical applications, particularly in the collection of blood samples for laboratory testing. sodium citrate is often added to blood collection tubes to maintain the integrity of blood samples, allowing for accurate analyses of blood components such as plasma.

Additionally, it is used in coagulation studies and tests, aiding in the assessment of blood clotting times. The buffering properties of sodium citrate, which help maintain a constant pH in solutions, contribute to its versatility in chemical and biochemical processes. The pharmacological actions of sodium citrate are essential for ensuring the proper handling of blood samples and facilitating diagnostic tests that rely on the evaluation of coagulation parameters.  

Pharmacodynamics: 

• Anticoagulant Action: sodium citrate functions as an anticoagulant by binding with calcium ions, an essential component in the coagulation cascade. This binding inhibits the conversion of prothrombin to thrombin, preventing the formation of fibrin and subsequent blood clotting. 
• Calcium Chelation: The chelation of calcium ions by sodium citrate leads to the formation of citrate-calcium complexes. By sequestering calcium, sodium citrate disrupts the normal coagulation process and maintains blood in an anticoagulated state. 
• Blood Sample Preservation: In blood collection tubes containing sodium citrate, the anticoagulant action prevents clot formation and preserves the integrity of the collected blood sample. This is crucial for laboratory analyses that require liquid blood components, particularly plasma, rather than clotted blood. 
• Coagulation Studies: sodium citrate is commonly used in coagulation studies, such as prothrombin time (PT) and activated partial thromboplastin time (APTT). These tests assess the time it takes for blood to clot and are important in evaluating the coagulation system. 
• Buffering Properties: sodium citrate has buffering properties, helping to maintain a constant pH in solutions. This contributes to its stability in various formulations and applications.

Pharmacokinetics: 

• Absorption: sodium citrate is typically administered intravenously or added directly to blood collection tubes. Its absorption is not a key consideration, as it is introduced directly into the bloodstream during medical procedures. 
• Distribution: Upon administration, sodium citrate is distributed in the blood and acts as an anticoagulant throughout the circulatory system. Its distribution is influenced by blood flow dynamics. 
• Metabolism: sodium citrate does not undergo significant metabolism in the body. It primarily functions as a chelating agent by binding with calcium ions, disrupting the coagulation cascade. 
• Elimination and excretion: sodium citrate is excreted through the kidneys. Since it is a substance that is not metabolized in a traditional sense, the elimination is primarily dependent on renal excretion. 

Adminstartion

Administration: 

• Blood Collection Tubes: sodium citrate is often pre-packaged in blood collection tubes. These tubes may be commercially available and are designed to contain a specific concentration of sodium citrate. 
• Intravenous Administration: In some medical procedures, sodium citrate may be administered directly into the bloodstream intravenously. This is more common in certain clinical situations where anticoagulation is required, and precise control over the anticoagulant effect is necessary. 
• Blood Sample Collection: Blood is drawn directly into the sodium citrate-containing tubes during venipuncture. The anticoagulant properties of sodium citrate prevent the blood from clotting, allowing for the collection of liquid blood components, particularly plasma. 
• Proportion and Mixing: The ratio of sodium citrate to blood volume is crucial for proper anticoagulation. Laboratory professionals ensure accurate proportions during blood sample collection. 
• Gentle Inversion or Mixing: After blood collection, the tubes containing sodium citrate and blood are gently inverted or mixed to ensure proper distribution of the anticoagulant. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: sodium citrate 

Pronounced: (So-dee-um Sy-trate)  

Why do we use sodium citrate? 

sodium citrate is commonly used as an anticoagulant in blood collection tubes. It prevents blood clotting by chelating calcium ions, allowing for the collection of liquid blood components, particularly plasma. This is crucial for various laboratory tests, including coagulation studies. sodium citrate is used in coagulation studies such as prothrombin time (PT) and activated partial thromboplastin time (APTT).

These tests assess the time it takes for blood to clot and provide valuable information about the coagulation system. The anticoagulant properties of sodium citrate contribute to the preservation of blood samples for laboratory testing. It ensures that blood remains in a liquid state, facilitating accurate analyses of blood components. In some medical situations, sodium citrate may be used to alkalinize urine. This can be relevant in the management of certain urinary tract conditions.