Pre-anaesthetic medication medication management for GPs

In this episode of The Good GP, host Julia Rawlinson welcomes Dr Erin Horsley, an experienced GP anaesthetist, to provide practical guidance on pre-anaesthetic medication management for general practitioners. Focusing on how to prepare patients for elective surgery by knowing which medications to pause, continue, or adjust.Highlights include:SGLT2 inhibitors: Advice on withholding these medications prior to surgery, especially for diabetic patients, due to risk of euglycaemic diabetic ketoacidosis.Diabetes medications and insulin: Specific instructions for perioperative management in procedures such as colonoscopy and gastroscopy.GLP-1 receptor agonists: Discussion on Ozempic, Wegovy, and Mounjaro. They emphasise that stopping them is not routinely required. Instead, they recommend clear fluid fasting protocols.Anticoagulants and antiplatelet agents: Practical approaches for managing DOACs, warfarin, and antiplatelet therapy based on procedure risk, including guidance on bridging and specialist consultation.Other medications: Tips on ACE inhibitors, opioids, and pain medications regarding continuation or withholding.Useful GP actions: An accurate medication list, allergy documentation, and direct communication with anaesthetic teams or pre-admission clinics.Providing concise, evidence-based recommendations for medication management in the perioperative setting to assist GPs and ensure safer outcomes for their patients.Links & Resources: NSW CEC Guidelines on Perioperative management of anticoagulant and antiplatelet agentsWA Country Health Service Anaesthetic Services, Pre-operative Assessment and Investigations Guideline(good summary)Australian Diabetes Society Periprocedural DKA with SGLT-2 inhibitorAustralian Diabetes Society Perioperative Diabetes and Hyperglycaemia GuidelinesThe Good GP Podcast is a proud member of the Talking HealthTech Podcast Network - the premier audio destination for cutting-edge insights and thought leadership in healthcare delivery, innovation, digital health, healthcare ICT, and commercialisation. Learn more at www.talkinghealthtech.com/podcast/networkIf you have any questions or would like to contact The Good GP, send an email to thegoodgp@gmail.com. Visit www.thegoodgp.com.au for previous episodes and more information. You can also find us on our Instagram page: @thegoodgppodcast. Follow us for more updates!