Perioperative and concomitant medicines management

Abstract

Perioperative medicines management remains an important part of surgical and perioperative care. This article provides practical guidance for clinicians on managing medicines during the perioperative period. It aims to summarize the biochemical pathways underpinning common drugs, provide succinct overviews of the considerations around perioperative medicines management, and signpost readers to key recommendations. The paper is structured according to body systems, and subsections on each key category of medicines. In each section, there will be a succinct narrative overview, usually accompanied by a diagram of drug pathways, and a table containing key information. Each overview provides an approach to consider the corresponding category of medicines, and key considerations or recommendations. Each diagram will contain the contextual physiology and drug targets. Each table will include key information about drugs, including mechanism of action, perioperative recommendations, and specific considerations. By taking a systematic approach and developing a thorough understanding of pharmacology, the surgeon can effectively contribute within a multidisciplinary team and provide the best possible care for patients throughout their journey.