Abrupt withdrawal of drugs to prepare for surgery can be dangerous

September 21, 2000

Editorial: The risks of interrupting drug treatment before surgery

Abruptly stopping drug treatments before surgery can be dangerous and increase the risk of postoperative complications, suggests an editorial in this week's BMJ.

Surgery, particularly major abdominal surgery, affects the rate at which stomach contents are emptied, so reducing the absorption of drugs. Patients may therefore have to wait several days before they can resume their normal medical routine.

Noble and Kehlet cite research showing a significantly increased risk of adverse outcomes among patients whose drug regimens had been stopped before surgery. Patients taking therapeutic drugs that were unrelated to their surgery were three times as likely to have complications as those not taking medicines. And the longer the duration of abstinence, the higher was the complication rate.

Doctors need to ensure that drug treatments are resumed as soon as possible, write the authors, by providing alternative routes, medicines, and by reducing the need for opioid anaesthesia. But the pharmaceutical industry also needs to do more, they say. Guidance should be included in drug information leaftlets and in national drug formularies to help doctors provide alternative medicines and be aware of the symptoms associated with sudden withdrawal from treatment.

"Such is the scale of the problem that failing to prevent the consequences of drug withdrawal in the postoperative period should possibly be considered equivalent to those medication errors that have been called 'worse than a crime', " conclude the authors.

Dr David Noble, Department of Anaesthesia, Intensive Care and Hyperbaric Medicine, Grampian University Hospitals, Aberdeen, Scotland
Email: david.noble@arh.grampian.scot.nhs.uk


Related Drugs Articles from Brightsurf:

The danger of Z-drugs for dementia patients
Strong sleeping pills known as 'Z-drugs' are linked with an increased risk of falls, fractures and stroke among people with dementia, according to new research.

Wallflowers could lead to new drugs
Plant-derived chemicals called cardenolides - like digitoxin - have long been used to treat heart disease, and have shown potential as cancer therapies.

Bristol pioneers use of VR for designing new drugs
Researchers at the University of Bristol are pioneering the use of virtual reality (VR) as a tool to design the next generation of drug treatments.

Towards better anti-cancer drugs
The Bayreuth biochemist Dr. Claus-D. Kuhn and his research team have deciphered how the important human oncogene CDK8 is activated in cells of healthy individuals.

Separating drugs with MagLev
The composition of suspicious powders that may contain illicit drugs can be analyzed using a quick and simple method called magneto-Archimedes levitation (MagLev), according to a new study published in the journal Angewandte Chemie.

People are more likely to try drugs for the first time during the summer
American teenagers and adults are more likely to try illegal or recreational drugs for the first time in the summer, a new study shows.

Drugs used to enhance sexual experiences, especially in UK
Combining drugs with sex is common regardless of gender or sexual orientation, reveals new research by UCL and the Global Drug Survey into global trends of substance-linked sex.

Promising new drugs for old pathogen Mtb
UConn researchers are targeting a metabolic pathway, the dihydrofolate reductase pathway, crucial for amino acid synthesis to treat TB infections.

Can psychedelic drugs heal?
Many people think of psychedelics as relics from the hippie generation or something taken by ravers and music festival-goers, but they may one day be used to treat disorders ranging from social anxiety to depression, according to research presented at the annual convention of the American Psychological Association.

New uses for existing antiviral drugs
Broad-spectrum antiviral drugs work against a range of viral diseases, but developing them can be costly and time consuming.

Read More: Drugs News and Drugs Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.