Perioperative medication management

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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).