To understand what these poisons do, it is necessary to have some understanding of how blood clots. A blood vessel is sort of like a pipe carrying rapidly flowing blood along its path. The pipe is lined by smooth flat cells called endothelial cells that facilitate the smooth flow of blood. If the pipe breaks, the structure of the pipe below the lining is exposed to the flowing blood inside. From there the sequence of events is as follows:
The blood vessel automatically constricts and spasms. This restricts the blood flowing to the damaged area and helps minimize blood loss.
The exposed pipe attracts circulating platelets, cloud-like cells that circulate ready to assist in clotting should the need arise. Platelets clump together over the tear in the blood vessel, forming a plug within the first five minutes of the injury. This is all a good thing but the platelets will not stay in place unless a substance called fibrin can be made to bind them.
Generating fibrin is complicated and beyond the scope of this article, but a cascade of activating proteins is needed to make the tiny protein threads (fibrin) that bind the platelets and makes a permanent platelet plug on the wound. Four of the proteins involved are called serine proteases, and these are the factors relevant to anticoagulant rat poisoning. These four factors must be able to work or there will be no fibrin, the platelets will not clump properly, and bleeding will continue without clotting.
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