Pulmonary Risk/Meds
Does well controlled asthma increase your risk of post operative pulmonary complications
No
How long prior to surgery Should beta blockers be stopped
How long before surgery should GLP-1 medications be hled
1 week
none, take normal morning dose
How long prior to surgery should Theophylline be held
evening prior to surgery
How long prior to surgery should alpha 2 agonists (Clonidine) be held
Do not stop
For diabetics with long acting and prandial insulin dosing what should their insulin regimen be prior to surgery
stop prandial dosing, reduce long acting dose by 50%
What steroid is given preoperatively for HPA suppressed patients?
Hydrocortisone
How long should a patient stop smoking prior to surgery
for at least four to eight weeks
How long prior to surgery should calcium channel blockers be stopped
generally, should not be stopped
What risks are associated with metformin that make us want to hold them prior to surgery
risk of kidney hypoperfusion, lactate accumulation, and tissue hypoxia
What is the first test when assessing HPA suppression
morning serum cortisol
What questionnaire should be used to assess for OSA?
STOP BANG
When should ACEi/ARBs be restarted after surgery
within 48 hours
How long before surgery should SGLT2 inhibitors be held
3-4 days prior to surgery
For patients with HPA suppression what dose of steroids should they be given for moderate risk procedures?
50 mg pre operatively and 25 mg Q8H for 24 hours
how should a patient taking ≥750 mcg daily of fluticasone (1500 mcg daily for other IGCs) for more than three weeks prior to surgery be managed?
HPA suppression testing
4 weeks
For T2DM with morning long-acting insulin dosing and no hx of hypoglycemia what should the dose on insulin be reduced by
No dose reduction
For patients taking ≥2 g/day of high potency or super high potency topical corticosteroids for what time period would you expect HPA suppression?
> 3 weeks