Drugs stopped preop for CTS
- ASA: 3 - 7 days, though some surgeons continue. Decreased perioperative mortality.
- Clopidogrel (Plavix): 5 - 7 days.
- Abciximab (Reopro): 12 - 24 h
- Eptifibatide (Integrilin): 2 - 4 h
- Tirofiban (Aggrastat): 2 - 4 h
- LMWH: 12 h
- UFH: 4 - 8 h or not stopped.
- Warfarin: 4 days
- Thrombolytic Tx (tPA): surgery should be delayed at least 24 h.
- NSAID, Omega-3-fatty acids (fish oils), garlic, vitamin E, gingko, flavanoids: stop ASAP before surgery.
- Smoking: stop at least 4 weeks prior to surgery.
Hold cellcept for 10 days before and 2 weeks after surgery.
Hold Forteo (teriparatide) for 1 week before and 2 weeks after surgery.
Continue with steroids, use stress dose if patient has been on steroids for a long time.
D/c Metformin, switch Pt. to insulin