Page 493 - Saunders Comprehensive Review For NCLEX-RN

Anticoagulants, Antiplatelets, and Thrombolytics
These medications alter normal clotting factors and increase the risk of
hemorrhaging.
Acetylsalicylic acid (aspirin), clopidogrel, and nonsteroidal antiinflammatory
drugs are commonly used medications that can alter platelet aggregation.
These medications should be discontinued at least 48 hours before surgery or as
specified by the surgeon; clopidogrel usually has to be discontinued 5 days before
surgery.
Anticonvulsants

Long-term use of certain anticonvulsants can alter the metabolism of anesthetic
agents.
Antidepressants

Antidepressants may lower the blood pressure during anesthesia.
Antidysrhythmics

Antidysrhythmic medications reduce cardiac contractility and impair cardiac
conduction during anesthesia.
Antihypertensives

Antihypertensive medications can interact with anesthetic agents and cause
bradycardia, hypotension, and impaired circulation.

Corticosteroids

Corticosteroids cause adrenal atrophy and reduce the ability of the body to
withstand stress.
Before and during surgery, dosages may be increased temporarily.

Diuretics
Diuretics potentiate electrolyte imbalances after surgery.

Herbal Substances
Herbal substances can interact with anesthesia and cause a variety of adverse
effects. These substances may need to be stopped at a specific time before surgery.
During the preoperative period, the client needs to be asked if he or she is taking an
herbal substance.
Insulin

The need for insulin after surgery in a diabetic may be reduced because the client’s
nutritional intake is decreased, or the need for insulin may be increased because of
the stress response and intravenous administration of glucose solutions.

Adapted from Potter P, Perry A, Stockert P, Hall A: Fundamentals of nursing, ed 8, St.
Louis, 2013, Mosby.

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