NEJM updates

Question 1

When should the following drugs be with held before surgery?

• SGLT inhibitors
• DPP4 inibitors
• GLP1 agonists
• metformin
• sulfonylureas

Answer 1

1. SGLT inhibitors - 3 days before
2. Others - with hold the morning of

Insulin - give 60-80% of basal dose

Question 2

Which patient group with heart failure should an SGLT2 inhibitor be commenced?

Answer 2

Dapagliflozin for HFrEF with AND without diabetes

Lowers risks for all-cause mortality,
cardiovascular death, and worsening HF

Question 3

Patients with metastatic CRC and BRAF V600E are often resistant to egfr inhibitors.

What is a suitable regime for BRAF VF00E metastastic CRC patients?

Answer 3

EGFR mab cetuximab + BRAF inhibitor (encorafenib) +/- MEK inhibitor (bimenitinib)