Should I continue or discontinue that medication?

Patients are admitted for surgery while taking a wide array of medications, and nurse anesthetists must evaluate their effectiveness and compatibility with anesthesia. Anesthetists must be familiar with the basic pharmacology of each drug and the potential adverse effects and possible drug interactions that may occur when anesthetic drugs are administered. If a medication requires discontinuation, we must ensure that the patient's disease remains controlled throughout the perioperative period. It is estimated that up to 50% of patients admitted for surgery will be taking some of type of medication preoperatively. The most common types are the drugs used to treat cardiovascular, central nervous system, and gastrointestinal disorders. There are few clinical or evidence-based guidelines regarding the preoperative management of many of these drugs. Most medications taken for minor disorders that do not have systemic effects can be safely continued without incident. Some medications may require discontinuation or temporary alteration of the dosing schedule to avoid problems in the perioperative period. This course reviews the current literature regarding the anesthetic management of several commonly encountered drug classes.