Preoperative Medication List

Before your surgeon can prescribe any medication he needs to know what you are already on. Most people are good at remembering the drugs they get from the doctor but it's also necessary to tell him about any medicines bought over-the-counter or obtained from an alternative practitioner or health food shop, remember to add these to your medication list.

Before you go for your pre-op assessment make a list of all the medicines you take along with the doses. Your doctor should be able to provide you a print out of the ones she prescribes along with the doses but you will need to add any others yourself.

The Preoperative Medication List Review
Important Points

The medicines that your doctor will focus on during the medication review are: -

• Blood thinners e.g. aspirin or clopidogrel. These medicines are often used by people with ischemic (restriction in blood supply) heart disease or who have suffered an ischemic cerebrovascular event (a stroke). You will be instructed to stop these at least one week before the operation in order to reduce the amount of blood lost during the procedure.

• Other cardiovascular medication. If you take other medication for a cardiovascular problem you will be advised to take these up to, and on the morning, of surgery. Examples of these drugs are anti-hypertensives, diuretics or vasodilators.
• Oral contraceptive pills significantly increase the risk of thrombosis (DVT) and must be stopped at least one month prior to surgery. Anti-thrombotic prophylaxis (medication to prevent a thrombosis) is particularly important for patients who have been taking oral contraceptives and your surgeon may give you a subcutaneous injection.
• Warfarin - which prevents blood from clotting must also be stopped several days before surgery so that it does not reduce your blood's ability to coagulate during and after the operation.
• It is also advised that psychiatric drugs like imipramine and monoamine oxidase inhibitors are stopped prior to surgery. These drugs can act on the sympathetic nervous system and increase both heart rate and blood pressure.

Preoperative Medication List
Non-Prescribed Medication

Non-prescribed medicines or remedies can interact with those prescribed by your doctor with serious consequences. If you are taking anything he doesn't know about including over-the-counter medications and remedies bought from health shops or prescribed by alternative practitioners. 

If it has an effect on your body remember to include them on your medication list.

Good examples are aspirin and ginkgo biloba (see picture left). Aspirin, as you already know, is a pain killer whilst ginkgo biloba is a herb associated with improved memory functioning. In addition to these main effects both work as anticoagulants and so your surgeon must be told if you are using them regularly. After your operation you will be prescribed anticoagulants to ensure you don't get a DVT but the surgeon won't be able to get the dose right if he isn't aware that you are already taking other anti-coagulants regularly.

Don't take risks with your health, when you take in your preoperative medication list, include everything you're taking and let him work out what is significant and what's not

Related Links: 

Preparing for Surgery - includes pre-op exercises, mental preparation, hip precautions (essential!) and more 
Anesthetics - the pros and cons of general and regional anesthesia 
Preparing for Recovery - masses of tips on how to recovery quickly and safely

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