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Two issues relate to prescribing for the surgical patient: managing their previous medication during the metabolically stressful and starved perioperative period, and prescribing drugs required as a consequence of surgery. The author considers both issues, with particular attention paid to perioperative anticoagulation, fluids and analgesia, and prophylaxis.
Paracetamol overdose is common and potentially life-threatening, causing severe hepatocellular failure, acute renal tubular necrosis and death. This chapter lists top tips for its management through metabolic manipulation or decreasing absorption of the drug. Time from ingestion is key, and the reader is provided with treatment strategies based on time of presentation.
Oral bowel preparation was once commonly prescribed before elective colorectal surgery, but is now only required for a subset of procedures, as its use has been associated with harm. Therefore, caution must be exercised when prescribing; readers are informed of general rules when giving bowel preparation, absolute and relative contraindications, and provided with information on the most commonly used formulations.