Ear Center: Preoperative Surgery Instructions for Medications

IMPORTANT! PLEASE READ BEFORE YOUR OPERATION!

How to Manage Your Medications Prior to Your Operation

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List of Aspirin and Aspirin Containing Products [PDF]
Aspirin, Aspirin Products, and Ibuprofen
Coumadin®, Plavix®, Ticlid®, Brilinta® (Blood Thinners)
Diuretics (Fluid or Water Pills)
Diabetic Medications & Insulin
All Other Medications Including Medications to Decrease Stomach Acid
Inhalers for Asthma & Breathing Disorders
Diet Pills & Weight Loss Medications - This is very important!
Take Your Medications Along with You to the Surgical Facility
Latex Allergies
Common Food Allergies Associated with Latex Allergies
Acetaminophen (Tylenol®)
Vitamins & Herbs

  1. Aspirin, Aspirin Products, and Ibuprofen

    1. Aspirin and Aspirin containing products, including all "Baby Aspirin", should be stopped for two weeks prior to your operation. Please click here for a summary, although not all-inclusive, list of products that contain aspirin.
    2. Ibuprofen, ibuprofen containing products (Advil®, Motrin®, etc.), and all Non-Steroidal Anti-Inflammatory Drugs (NSAID'S such as Aleve®) should be stopped one week prior to your operation.
  2. Coumadin®, Plavix®, Ticlid®, Brilinta® (Blood Thinners)

    1. Coumadin® - Please notify your doctor immediately if you are taking Coumadin® (warfarin). Coumadin® should not be stopped unless specifically ordered by your doctor. In order to stop Coumadin®, you may need to be hospitalized, started on Heparin, and have the Coumadin® stopped. In rare circumstances and only with the advice of your physician, it is possible that some patients may be able to discontinue Coumadin® for brief periods of time.
    2. Plavix®, Ticlid®, Brilinta® – Please notify your doctor if you are taking Plavix®, Ticlid®, or Brilinta®. Plavix® and Ticlid® should be stopped for two weeks prior to your operation. However, stopping your medication needs to be coordinated with your primary care physician. Brilinta® must be stopped for two days prior to your operation.
  3. Diuretics (Fluid or Water Pills)

    1. Please notify your physician if you are taking any water pills (diuretics). Stop all diuretics one day prior to
      your operation. Do not take any diuretics on the morning of your operation. Your doctor may request a
      blood test prior to your operation in order to check your blood chemistries (sodium, potassium, chloride,
      etc.).
  4. Diabetic Medications & Insulin

    1. DO NOT TAKE YOUR MORNING ORAL HYPOGLYCEMICS (DIABETIC/SUGAR PILLS) ON THE DAY OF YOUR OPERATION.
    2. DO NOT TAKE YOUR MORNING INSULIN ON THE DAY OF YOUR OPERATION. PLEASE BRING YOUR INSULIN WITH YOU TO THE SURGICAL FACILITY.
    3. ANY PATIENT WHO FEELS HYPOGLYCEMIC (LOW BLOOD SUGAR) SHOULD DRINK SUGAR CONTAINING CLEAR LIQUIDS SUCH AS APPLE JUICE OR GINGER-ALE.
    4. YOUR BLOOD SUGAR LEVEL WILL BE MONITORED BY THE ANESTHESIOLOGIST PRIOR TO YOUR OPERATION AND DURING YOUR OPERATION. IF NEEDED, AN APPROPRIATE AMOUNT OF INSULIN WILL BE ADMINISTERED TO MAINTAIN YOUR BLOOD SUGAR AT A REASONABLE LEVEL.
  5. All Other Medications Including Medications to Decrease Stomach Acid

    1. Take all other morning medications with a sip of water prior to leaving your home. This is especially important for all blood pressure medicines, heart medicines, breathing pills, birth control pills, thyroid medications, and medications to decrease stomach acid.
  6. Inhalers for Asthma & Breathing Disorders

    1. If you use an inhaler(s) to help you breathe, use it (them) in the morning prior to leaving your home. Please bring all of your inhalers with you to the surgical facility.
    2. Stop all nasal inhalers one day prior to your operation, and do not use any nasal inhalers on the morning of your operation.
    3. If you have had either a nasal or sinus operation, do not restart your nasal inhalers after your operation without first discussing it with your surgeon.
  7. Diet Pills & Weight Loss Medications - THIS IS VERY IMPORTANT!!

    1. ANY "FEN-FEN" OR "FEN-FEN COMBINATION PRODUCTS" (DIET PILLS) NEED TO BE DISCONTINUED FOR TWO WEEKS PRIOR TO YOUR OPERATION.
    2. PLEASE NOTIFY ALL OF YOUR PHYSICIANS, ESPECIALLY THE ANESTHESIOLOGIST, OF ANY PRIOR "FEN-FEN" USE. THIS IS VERY IMPORTANT AS THESE MEDICATIONS CAN AFFECT HEART FUNCTION.
    3. THESE MEDICATIONS CAUSE A DEPLETION OF THE BODY'S NATURAL CATECHOLAMINES (COMPOUNDS THAT AFFECT BLOOD PRESSURE, HEART RATE, ETC.) IF YOU HAVE BEEN TAKING DIET PILLS OR OTHER WEIGHT LOSS MEDICATIONS AND YOUR CATECHOLAMINE LEVELS ARE REDUCED, SERIOUS DECREASES IN BLOOD PRESSURE THAT ARE DIFFICULT TO INCREASE MAY OCCUR DURING GENERAL ANESTHESIA.
    4. HAVE BEEN TAKING DIET MEDICATIONS, THE ANESTHESIOLOGIST AND YOUR DOCTOR WILL WANT YOU TO STOP TAKING ALL OF THE MEDICATIONS AND POSTPONE YOUR PROCEDURE FOR 2 WEEKS. BY POSTPONING, YOUR BODY WILL HAVE AN OPPORTUNITY TO REPLENISH IT NATURAL LEVEL OF CATECHOLAMINES.
    5. The followin is a partial list of diet pills:


      - Phentermine

      - Reduz

      - Ephedra (any type)

      - Tenuate (diethylpropion)

      - Qsymia (phentermine hydrochloride/topiramate
      )

  8. Take Your Medications Along with You to the Surgical Facility

    1. TAKE ALL OF YOUR MEDICATIONS, IN THEIR ORIGINAL BOTTLES, WITH YOU TO THE SURGICAL FACILITY ON THE DAY OF YOUR OPERATION.
    2. PLEASE CALL OUR OFFICE AT (336) 273-9932 IF YOU HAVE ANY QUESTIONS RELATED TO YOUR MEDICATIONS OR TO YOUR OPERATION IN GENERAL. ASK TO SPEAK TO ONE OF OUR NURSES WHO WILL BE GLAD TO ASSIST YOU.
  9. Latex Allergies

    Please notify your doctor if you or your child has a history of latex allergy.

  10. Common Food Allergies Associated with Latex Allergies
  • Almond
  • Apple
  • Avocado
  • Banana
  • Cantaloupe
  • Celery
  • Cherry
  • Chestnut
  • Citrus
  • Fig
  • Kiwi
  • Mango
  • Melon
  • Papaya
  • Passion Fruit
  • Peach
  • Pear
  • Pineapple
  • Potato
  • Spinach
  • Strawberry
  • Tomato
  • Turnip
  • Wheat

Acetaminophen (Tylenol®)

Acetaminophen (Tylenol®) may be used preoperatively and postoperatively for pain control and for treating fever. Please read the instructions packaged with all acetaminophen containing products and adhere to all recommendations and dosage specifications. To help prevent potential acetaminophen toxicity, especially in children, it is very important for children to receive the proper dose and to have subsequent doses given at the proper intervals.

During some operations, acetaminophen (Ofirmev®) may be given intravenously. To help prevent potential toxicity, it is important that you or your child do not receive additional doses of acetaminophen for 6 hours after receiving Ofirmev®.

Click here for a list of medications that contain acetaminophen.

Vitamins & Herbs

The following vitamins and herbal supplements may cause abnormal bleeding problems and my affect your cardiovascular system (heart and blood vessels). These substances may affect your surgical outcome and safety.

These vitamins/herbal supplements should be avoided for at least two weeks prior to your operation.

Dong Quai
Echinacea
Ephedra
Feverfew
Fish Oils (Omega-3 Fatty acids)
Garlic
Gingko Biloba
Ginseng
Glucosamine
Goldenseal
Kava
Licorice
St. John's Wort (all types)
Valerian
Vitamin C (more than 2000 mg daily)
Vitamin E (more than 4000 mg daily)

 

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Last revised October 17, 2014