Peri-op oral hypoglycemics

[deleted697535]

For elective cases what do you guys do with these?
There's about 8 approved classes now afaik...

Hold them all? Continue or decr dose?

Or be fancy and only hold the ones that can cause hypos but continue the rest that prevent hypers ?(eg metformin, glitazones)

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[BLADEMDA]

Canagliflozin: A Novel SGLT2 Inhibitor for Type 2 Diabetes Mellitus

SGLT2 may exacerbate hypotension due to ACE inhibitors under GA. This is one to hold the night before (24 hours prior to surgery).

May cause hypotension and Hyperkalemia

 

[Noyac]

Depends on the surgery

 

[coffeebythelake]

Depends on the surgery

Best answer.

 

[GA8314]

For elective cases what do you guys do with these?
There's about 8 approved classes now afaik...

Hold them all? Continue or decr dose?

Or be fancy and only hold the ones that can cause hypos but continue the rest that prevent hypers ?(eg metformin, glitazones)

I hear you. It has gotten rather confusing with all of the newer brand names out there. We, currently only hold metformin due to what seems (upon delving) like academic dogma relative to LA.... We should probably revisit our policy.

What does everyone do about metformin out of curiosity?

 

[dannyboy1]

By the time I see them in holding it’s too late. If really concerned get a finger stick intraop. Decadron for PONV also can help prevent hypoglycemia

 

[d9sccr]

By the time I see them in holding it’s too late. If really concerned get a finger stick intraop. Decadron for PONV also can help prevent hypoglycemia

Seems like the PSH model isn't being applied correctly...tsk tsk

 

[anbuitachi]

I hear you. It has gotten rather confusing with all of the newer brand names out there. We, currently only hold metformin due to what seems (upon delving) like academic dogma relative to LA.... We should probably revisit our policy.

What does everyone do about metformin out of curiosity?

keep taking

 

[Psai]

I hear you. It has gotten rather confusing with all of the newer brand names out there. We, currently only hold metformin due to what seems (upon delving) like academic dogma relative to LA.... We should probably revisit our policy.

What does everyone do about metformin out of curiosity?

I would only stop if they have some renal dysfunction because I believe that's the population that gets lactic acidosis