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peri_operative_medication_management [2026/04/09 03:24] – [Rheumatologic Medications] Scott Larsonperi_operative_medication_management [2026/04/09 03:30] (current) – Scott Larson
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 ====== Peri-Operative Medication Management ====== ====== Peri-Operative Medication Management ======
-FIXME+
 ====Cardiovascular and Hypertensive Medication==== ====Cardiovascular and Hypertensive Medication====
   * Beta Blockers- continue through surgery    * Beta Blockers- continue through surgery 
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   * If patient is on an mTOR inhibitor (sirolimus or everolimus), recommend discussion with nephrology prior to surgery as these can cause post-op wound healing issues, seromas and lymphoceles.   * If patient is on an mTOR inhibitor (sirolimus or everolimus), recommend discussion with nephrology prior to surgery as these can cause post-op wound healing issues, seromas and lymphoceles.
  
-11.  Hematology/Oncology Medication-Best to discuss IN ADVANCE OF SURGERY with Hematologist and surgeon for guidance during perioperative period. +====Hematology and Oncology Medications==== 
 +  * Best to discuss IN ADVANCE OF SURGERY with Hematologist and surgeon for guidance during perioperative period.
   * Palbociclib (Ibrance)-- can cause neutropenia, dosed 3 weeks on/1 week off to allow ANC to recover. May need to be held before surgery and up to 1 week after to allow for healing but needs to be discussed with oncologist MUCH PRIOR to surgery to coordinate   * Palbociclib (Ibrance)-- can cause neutropenia, dosed 3 weeks on/1 week off to allow ANC to recover. May need to be held before surgery and up to 1 week after to allow for healing but needs to be discussed with oncologist MUCH PRIOR to surgery to coordinate
   * Anastrozole (Arimidex), tamoxifen, letrozole, exemestane (Aromasin)-- hold 1 day prior to surgery and day of surgery due to risk for clotting. Should be held up to 1 week after surgery depending on mobility   * Anastrozole (Arimidex), tamoxifen, letrozole, exemestane (Aromasin)-- hold 1 day prior to surgery and day of surgery due to risk for clotting. Should be held up to 1 week after surgery depending on mobility
  
-12.  Parathyroid Hormone Analogs+====Parathyroid Hormone Analogs====
  
   * Teriparatide (Forteo) and other similar osteoporosis agents are ok to continue through surgery.   * Teriparatide (Forteo) and other similar osteoporosis agents are ok to continue through surgery.
  
-13.  PDE Inhibitors (i.e. sildenafil)+====PDE Inhibitors (i.e. sildenafil)====
  
   * If for ED, hold for 24 hrs prior to surgery. Continue if for pulmonary HTN.   * If for ED, hold for 24 hrs prior to surgery. Continue if for pulmonary HTN.
  
-14. Herbal Medications+====Herbal Medications====
   * CBD oil should also be held for 1 week prior to surgery.    * CBD oil should also be held for 1 week prior to surgery. 
   * Stop ALL herbal supplements for 1 week prior to surgery.   * Stop ALL herbal supplements for 1 week prior to surgery.