Perioperative Medication Management Flashcards Preview

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Flashcards in Perioperative Medication Management Deck (27)
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1
Q

What pre-op blood sugar in diabetics is associated with surgical complications?

A

> 200

2
Q

How long can you take oral agents for DM?

A

Until the night before surgery

3
Q

Insulin

A

Decrease dose of intermediate-acting insulin morning of

Hold short-acting

4
Q

Beta-blockers & Surgery

A

Keep on board

Helps to reduce ischemia, control/prevent arrhythmias, and decrease angina

5
Q

ACEIs/ARBs & Surgery

A

Increased risk of preoperative hypotension

Stop prior to surgery: hard on kidneys

6
Q

Cardiovascular drug that has limited data & appears to be safe with surgery

A

CCBs

7
Q

Alpha-s Agonists & Surgery

A

Potentially beneficial
Possible rebound HTN if removed
Switch to transdermal

8
Q

Diuretics & Surgery

A

D/C 48 hours prior to surgery

9
Q

What risks are associated with diuretics & surgery?

A

Hypotension

Hypokalemia

10
Q

H2 Blockers & PPIs & Surgery

A

Potentially beneficial due to increased mucus production

Take night prior to surgery

11
Q

Inhaled Beta-Agonists & Anti-Cholinergics & Surgery

A

Beneficial post-op pulmonary effects

Administer morning of surgery

12
Q

Leukotriene Inhibitors & Surgery

A

Used through morning of surgery

13
Q

Corticosteroids & Surgery

A

Continue

Increase dose 2-3 days due to stress of surgery

14
Q

Theophylline & Surgery

A

D/C night before

15
Q

Niacin/Fibric Acid & Surgery

A

D/C in perioperative period

16
Q

Atorvastin/Pravastatin & Surgery

A

Risk of myopathy

Studies ongoing: leaning towards continuation

17
Q

Thyroxine & Surgery

A

Safely withheld for 5-7 days

IV if necessary at 80%

18
Q

Aspirin & Surgery

A

Increased risk of bleeding if continued
Increased risk of thrombosis if discontinued
Usually discontinued: low molecular weight heparin

19
Q

Warfarin & Surgery

A

D/C 2-4 days prior to surgery due to increased risk of bleeding

20
Q

Antidepressants & Surgery

A

Take morning of & resume post op

21
Q

NSAIDs & Surgery

A

D/C 7-10 days prior

22
Q

Pre-Operative Medications

A

Antibiotics

Midazolam (Versed)

23
Q

Benefits of Midazolam (Versed)

A

Anxiolytic
Sedative
Induction of preoperative anesthesia

24
Q

Medications to Keep on Board with Surgery

A
Insulin: decrease morning dose
Beta-blockers
Alpha-s agonists: transdermal
Inhaled beta-agonist & anti-cholinergic
Leukotriene inhibitors
Corticosteroids
Atorvastin/Pravastatin
Antidepressants: unless CNS surgery
Aspirin?
25
Q

Medications to Caution with Surgery

A

Calcium channel blockers

26
Q

Medications to Hold the Morning of Surgery

A

Oral diabetic agents
ACEI/ARBs
H2 blockers/PPI

27
Q

Medications to Take off of Prior to Surgery

A
Diuretics: 48 hours prior
Theophylline: night before
Niacin/fibric acid derivatives
Thyroxine: 5-7 days prior
Aspirin: low molecular weight heparin instead
Clopidogrel/ticlodipine: 5 days prior
Warfarin: 2-4 days prior
NSAIDs: 7-10 days prior