Polypharmacy, Dosing Trends, and Drug-Drug Interaction Patterns After High-Level Limb Amputation Surgery

Area of Science:

• Pharmacology
• Surgical Outcomes
• Patient Safety

Background:

• Major amputation surgeries involve significant physiological changes.
• Perioperative medication management is complex in these patients.
• Understanding medication patterns is crucial for optimizing care.

Purpose of the Study:

• To investigate perioperative medication patterns in patients undergoing major amputation.
• To analyze medication dosing changes and drug-drug interactions.
• To identify trends in polypharmacy surrounding amputation procedures.

Main Methods:

• Retrospective chart review of 216 major amputation cases (transfemoral, hip disarticulation, hemipelvectomy, forequarter).
• Examination of medication use, dosing adjustments, and drug-drug interaction warnings.
• Analysis of data from preoperative and postoperative periods.

Main Results:

• Medication use increased in 76.9% of cases, with an average of 7 preoperative and 10 postoperative medications.
• Postoperative dosing remained the same for 74.3% of medications, with increases in 9.2%.
• Drug-drug interaction warnings (Types C, D, X) increased postoperatively, affecting 59.7%, 62.0%, and 5.1% of cases, respectively.

Conclusions:

• Polypharmacy is common preoperatively and increases postoperatively after major limb amputations.
• Medication dosing often remains stable or increases, alongside a rise in drug-drug interaction warnings.
• Further research and clinical attention are needed due to altered pharmacokinetics and pharmacodynamics.