Questions Flashcards
A vascular surgery registrar has requested a pre-operative consultation for a 66-year-old male patient scheduled for an aorto-bifemoral bypass procedure. He is known with: • Insulin dependent diabetes mellitus – well controlled with an HbA1c of 6% • A history of a myocardial infarction 1 year ago after which he had an angioplasty done and is currently asymptomatic • Atrial fibrillation that is rate controlled. His current METS is > 4 Current medications include: - Aspirin 150mg dly po - Protophane 30u mane and 20u nocte sc - Dabigatran 150mg b.d po - Diltiazem SR 90mg b.d po - Digoxin 0.25mg dly po a) What is his risk for developing an adverse event post-operatively and why? (2)
b) The registrar wants to know what to do with the following drugs pre-operatively and why?
i) Dabigatran. (2)
ii) Digoxin. (2)
iii) Diltiazem. (2) c) Would you start this patient on a beta blocker preoperatively? Motivate your answer. (2)
