Perioperative medication management
From IDWiki
| Medications | Recommendations |
|---|---|
| Cardiovascular Medications | |
| Beta blockers | Continue. Use IV propanolol, metoprolol, or labetalol if strictly NPO. |
| Alpha-2 agonists | Continue. Use transdermal clonidine if strictly NPO. |
| Calcium channel blockers | Continue. Can hold if strictly NPO. |
| ACE inhibitors and ARBs | Hold morning dose, unless indicated for heart failure or poorly-controlled hypertension. Can use IV enalapril if needed. |
| Diuretics | Hold morning dose. Use IV formulations if needed. |
| Statins | Continue. |
| Non-statin lipid-lowering medications | Discontinue the day before surgery. Resume with oral intake. |
| Gastrointestinal Medications | |
| H2 blockers | Continue. Substitute IV formulations if necessary and strictly NPO. |
| PPIs | Continue. Substitute IV formulations if necessary and strictly NPO. |
| Respiratory Medications | |
| Inhaled bronchodilators | Continue. |
| Theophylline | Discontinue the evening before surgery. |
| Leukotriene inhibitors | Continue. |
| Estrogen and Related Hormones | |
| OCP | If low risk of VTE from surgery, continue. If high risk of VTE from surgery, stop 4 weeks before. |
| Postmenopausal hormone replacement therapy | If low risk of VTE from surgery, continue. If high risk of VTE from surgery, stop 4 weeks before. |
| Selective estrogen receptor modulators | If low risk of VTE from surgery, continue. If high risk of VTE from surgery, stop 3 days before (raloxifene for breast cancer prevention or osteoporosis), 2 weeks (tamoxifen for breast cancer prevention), continue (tamoxifen for breast cancer treatment). |
