Perioperative Medication Management

Steven L. Cohn, MD, FACP, SFHM

SUMMARY

Although general internists and subspecialists are familiar with prescribing and managing medications in typical outpatient and inpatient venues, the perioperative period represents a challenging and often unfamiliar setting. This module will outline the principles, available evidence, and expert opinion to be considered when making perioperative management recommendations for some of the most commonly prescribed medications.

GOAL

To provide hospitalists/consultants with the information necessary to appropriately manage a patient’s medications in the perioperative period.

TARGET AUDIENCE

This activity is designed for hospitalists and other physicians serving as consultants to patients undergoing surgery. 

LEARNING OBJECTIVES

After completing the module, the participant should be able to:

  1. Analyze the risks and benefits underlying perioperative management of antiplatelet and anticoagulant medications.
  2. Recognize the importance of continuing most cardiovascular medications perioperatively.
  3. Recognize the importance of continuing most pulmonary medications perioperatively.
  4. Assess when stress dose steroids are indicated and manage other endocrine medications in the perioperative period.
  5. List the theoretical risks of continuing neuropsychiatric medications and decide whether or not to discontinue them.
  6. Identify and discontinue herbal medications that may adversely impact perioperative outcomes.
  7. Analyze the risks and benefits underlying perioperative management of antirheumatic medications.

Accreditation Statements

The American Osteopathic Association (AOA) has approved this activity of the Society of Hospital Medicine for 2 AOA Category 2-B CME credits.

The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CME Statement Designation

The Society of Hospital Medicine designates this activity for a maximum of 2 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points [and patient safety MOC credit] in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Conflict of Interest Disclosure Policy

In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

Terms and Conditions

Readers may view, browse, and/or download material for temporary copying purposes only, provided these uses are for noncommercial personal purposes. Except as provided by law, this material may not be further reproduced, distributed, transmitted, modified, adapted, performed, displayed, published, or sold in whole or in part, without prior written permission from Wiley.

Release date: May 30, 2018           

Expiration date: May 30, 2021

Estimated time to complete activity: 2 hours

INSTRUCTIONS

The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of 3 sections: a pre-test, a study program, and a CME post-test. All 3 sections must be completed to receive CME credit.

Additional Information

Course summary
Available credit: 
  • 2.00 AMA PRA Category 1 Credit™
  • 2.00 ABIM MOC Self Evaluation Points
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points [and patient safety MOC credit] in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit
  • 2.00 Non-physician
Course opens: 
05/30/2018
Course expires: 
05/30/2021
Your cost:
$0.00
Parent activity set: 
Rating: 
0

The following relationships have been reported for this activity:

Leonard Feldman, MD, FACP, SFHM (Chair)
Associate Professor of Medicine
Johns Hopkins University School of Medicine
Med-Peds Urban Health Residency Program Director
Associate Program Director, Osler Medical Residency
Director, Comprehensive General Medicine Consult Service
Editor, Consultative, and Perioperative Medicine Essentials for Hospitalists
Baltimore, Maryland
Dr Feldman reports having no relevant financial or advisory relationships with corporate organizations related to this activity.
 
Kurt Pfeifer, MD, FACP, SFHM
Professor of Medicine
General Internal Medicine
Medical Director, Froedtert and Medical College of Wisconsin Eye Institute Perioperative Services
Medical College of Wisconsin
Associate Editor-in-Chief, Consultative & Perioperative Medicine Essentials for Hospitalists
Milwaukee, Wisconsin
Dr. Pfeifer reports having no relevant financial or advisory relationships with corporate organizations related to this activity

Steven L. Cohn, MD, FACP, SFHM
Medical Director – UHealth Preoperative Assessment Center
Director–UMH Medical Consultation Service
Professor of Clinical Medicine
University of Miami – Miller School of Medicine
Miami, Florida
Dr. Cohn reports having minor stock holdings in Bristol Myers Squibb, GlaxoSmithKline, Merck & Co, Inc, and Pfizer Inc; and serving on the Advisory Board for Portola and Speaker Honoria for Janssen
 
SHM CONFLICT OF INTEREST DISCLOSURE POLICY 

In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

Accreditation Statement

The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CME Statement Designation

The Society of Hospital Medicine designates this activity for a maximum of 2 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity

Available Credit

  • 2.00 AMA PRA Category 1 Credit™
  • 2.00 ABIM MOC Self Evaluation Points
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points [and patient safety MOC credit] in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit
  • 2.00 Non-physician

Accreditation Period

Course opens: 
05/30/2018
Course expires: 
05/30/2021

Price

Your cost:
$0.00
Please login or register to take this course.

The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of several sections: a pre-test, a study program, a post-test, & CME evaluation. All sections must be completed to receive CME credit.

Click START to begin.