Drugs to be stopped before surgery. 1. Oral hypoglycemic – If Minor surgery – Omit morning dose If Major surgery – Switch to insulin 48hrs before , and then omit morning dose of insulin on day of surgery 2. OCP – Estrogen containing pills to be stopped 4 weeks before surgery. (Progesterone only pills can be continued) 3. MAO inhibitors – discontinue 3 weeks before Surgery 4. Oral Anticoagulant – Stop 1 wk before and switch to low molecular weight heparin (which is stopped 1 day before surgery) 5. Aspirin – stop 48 – 72 hrs before 6. Lithium – stop 48 – 72 hrs before. 7. ACE Inhibitors. Note: Smoking should be stopped 6 weeks before surgery. Even if not stopped then, it will still benefit if stopped 12 hrs before surgery. Drugs that can be continued. Levodopa AntiHypertensive (except ACE inhibitors) AntiAnginals (except Aspirin) AntiThyroid drugs. Progesterone only pills STEROIDS : If patient took Steroid for > 1wk in last 1year – then intraop steroid replacement is necessary.
