Sodium citrate/citric acid (Bicitra) is an oral solution I most commonly administered as an anesthesiology resident for aspiration prophylaxis in patients at high risk for aspiration (e.g., obstetric patients prior to C-section) to neutralize gastric acid.

Furthermore, for patients with chronic kidney disease with metabolic acidosis, bicarbonate supplementation may reduce disease progression. Bicitra can be used for this purpose to correct serum bicarbonate; however, swinging to the alkalotic extreme may actually result in increased mortality. Bicitra can also be used to alkalinize urine which can help with chemolysis of certain kidney stones.

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