Anticoagulants Flashcards
Concentration of EDTA
1.5-2.0mg/mL of blood
It removes ionized calcium through an irreversible process called chelation
EDTA
Three forms of EDTA
a. Dry form- VERSENE
(Na2 EDTA, K2 EDTA)
b. Liquid form- SEQUESTRENE
(K3 EDTA)
For routine cell count and blood smear preparation
EDTA
If EDTA exceeds 2.0mg/ml of whole blood, platelets may swell and fragment that will lead to _____ platelet count.
False increase platelet count
Not recommended for coagulation test
EDTA
Coagulation factors that are not stable in EDTA
Factors V and VIII (labile factors)
Effect of increase EDTA in ESR and hematocrit results
False decrease
Rare phenomenon that occur when using EDTA
platelet satellitosis
How to correct platelet satellitosis?
By using sodium citrate tube and multiply the result to 1.1.
Purpose of EDTA tubes
a. puple
b. pink
c. royal blue
d. tan
e. pearl (pale tint of white)
f. white with gel separator
a. PURPLE- routine hematology and HbA1c
b. PINK- hematology and blood bank
c. ROYAL BLUE- trace elements
d. TAN- lead determination
e. PEARL- platelet preparation tube (PPT)
f. WHITE- molecular test (PCR and DNA)
Binds to calcium and form soluble complex
Sodium citrate
Anticoagulant of choice in coagulation studies
Sodium Citrate (Blue top tube)
Anticoagulant of choice for Standard Westergren and ESR testing.
Sodium citrate (Black top tube)
Blood:Anticoagulant
a. blue top tube
b. black top tube
a. 9:1
b. 4:1
Preferred anticoagulant for ESR testing
Black top tube
Underfilling/excess citrate/short draw can cause _____ due to excess citrate in plasma
prolonged PT and PTT
Patient with increase hematocrit level (>55%)
polycythemic patient
Concentration of oxalate (black top tube)
1-2mg/ml
Different forms of oxalate
CLUE: “lisopodo
lithium oxalate
sodium oxalate
potassium oxalate
double oxalate
most widely used oxalate
potassium oxalate
used as an alternative for prothrombin time (PT) test
oxalated plasma
double balanced plasma components
potassium oxalate + ammonium oxalate
3 parts = can cause cell swelling
2 parts = can cause cell shrinkage
Ammonium oxalate (winthrobe’s)
Potassium oxalate (paul heller’s)
acid mucopolysaccharide that inhibits coagulation by inactivation of thrombin
Heparin
used as an in vitro and in vivo anticoagulant
heparin
anticoagulant of choice on most chemistry test
lithium heparin
optimum concentration of heparin
0.2mg/ml of blood
reason why heparin is not for coagulation studies
it inhibits all stages of coagulation cascade especially thrombin
reason why heparin is not for blood film preparation
it destroys WBC and platelets and can produce bluish background on romanowsky stained smear
heparin is anticoagulant for _____
osmotic fragility test and LAP test
used in preserving glucose, inhibitor of glycolysis and determination of lactic and blood alcohol/ethanol
sodium fluoride (gray top tube)
Blood culture specimen collections in microbiology
sodium polyanethol sulfonate (SPS)
Used in blood bank studies, lymphocytotoxicity testing, HLA phenotyping, DNA and paternity testing
acid citrate dextrose (ACD)
A. It inhibits the labile factors
B. It preserves the labile factors
A. EDTA
B. Sodium citrate
Used during Percutaneous Transluminal Coronary Angioplasty (PTCA) and Cardiopulmonary Bypass (CPB) to prevent clot formation
Heparin
Inversions in Red Top Tube
a. glass
b. plastic
a. no inversions
b. 5 inversions
a. First tube in the order of draw
b. Last tube in the order of draw
a. Yellow top tube - SPS
b. Yellow top tube - ACD
CTAD (sodium citrate)
Citrate
Theophylline
Adenosine
Dipyridamole
