USMLE Step 2 (Fach) / Surgery (Lektion)

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Vorderseite Discontinuation of drugs before surgery
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Antidiabetic drugs:- Metformin: discontinue 2 days before and after surgery- Discontinue other oral hypoglycemics on the day of surgery and postoperatively until the patient is no longer NPO.- Insulin: Discontinue on the day of surgery but administer IV intraoperatively.

Antihypertensive drugs:- Discontinue the following antihypertensives one day before surgery and continue postoperatively:→ ACE inhibitors→ ARBs→ Diuretics- Continue all other antihypertensives

Antianginal drugs: Continue

Statins: Continue

Oral contraceptives: Discontinue 4 weeks before surgery

Psychiatric drugs:- Benzodiazepines: May be continued- Lithium: Discontinue 3 days before surgery.- Tricyclic antidepressants: Discontinue intraoperatively.

Antiepileptics: Continue

Anticoagulant or antiplatelet drugs- Antiplatelet drugs (e.g., aspirin, clopidogrel): Discontinue all antiplatelet drugs one week before surgery.- Direct oral anticoagulants (e.g., dabigatran, rivaroxaban): Discontinue medication 2 days before surgery.- Warfarin: Discontinue warfarin 5 days before surgery.- Continue heparin and warfarin postoperatively

Thyroxine: Discontinue intraoperatively and resume postoperatively.

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