General approach

The patient’s comorbidities and planned procedure must be considered when managing medications in the perioperative period. Some medications have beneficial effects during surgical procedures, whereas others may be detrimental. In some cases, withdrawal of medications suddenly can have a negative effect. Therefore, optimal modifications to a patient’s chronic medication regimen is of key importance.

Most medications are continued as normal, and the main areas that require modification are:

• anticoagulants and antiplatelet medications
• diabetes-related medicines
• rheumatological and immunological medications

Resources

Should any further information be needed other than what is present in this protocol, ‘The Handbook of Perioperative Medicines’ by the UKPCA is a comprehensive resource, and can be accessed here.

In this resource, pre-existing specialist guidance that is authorised for use in The Beacon and on Q-Pulse supercedes advice by the UKPCA handbook.

The guide has partitioned medicines into their usual area of clinical application, but can also be searched to find specific medicines.

Nomenclature

Throughout this document, medications are referred to by their generic rather than brand name. This constitutes best practice, regardless of what constitutes individual clinician preference.

For example, lercanidipine is used, not Zanidip.

Brand names are not found in this guide, except for very few key circumstances.