ABSTRACT

Background: This review article discusses the pharmacology of the most commonly used chronic medications in patients undergoing elective surgical procedures. The mechanism of action and adverse side effects of cardiovascular medications (e.g., beta blockers, alpha-2 agonist, calcium channel blockers, ACE inhibitors, diuretics), lipid-lowering drugs, gastrointestinal medications (H2-blockers, proton pump inhibitors), pulmonary medications (inhaled β-agonists, anticholinergics,), antibiotics (tetracyclines, clindamycin and macrolide, linezolid), opioids and non-opioids analgesics (NSAIDs, COX-2 inhibitors, acetaminophen), gabapentanoids, erectile dysfunction (ED) drugs, and psychotropic drugs (tricyclic antidepressants [TCAs], monoamine oxidase inhibitors [MAOI], selective serotonin reuptake inhibitors [SSRIs], serotonin norepinephrine reuptake inhibitors [SNRIs], and cannabinol-containing drugs) will be reviewed.

Materials and Methods: An online search was conducted from January 2000 through February 2021 with the Medline database through PubMed and Google Scholar using the following search terms/keywords: “chronic medications in the perioperative period”, and “chronic medications and anesthetic implications.” In addition, we searched for anesthetic side effects associated with the major drug groups.

Results and Conclusions: An understanding of the pharmacology and pharmacokinetics of most used chronic medications is important to avoid untoward outcomes in the perioperative period. These drug interactions may result in altered efficacy and toxicity of the anesthetic medications administered during surgery. These drug-drug interactions can also effect the morbidity, mortality, and recovery time of surgical patients. Part I of this two-part review article focuses on the mechanisms of action and adverse side effects of the chronic medications most commonly taken by surgical patients in the preoperative period.

摘要

背景：这篇综述文章讨论了在接受选择性外科手术的患者中最常用的慢性药物的药理学。心血管药物（如β受体阻滞剂、α2受体激动剂、钙通道阻滞剂、ACE抑制剂、利尿剂）、降脂药物、胃肠药物（H2受体阻滞剂、质子泵抑制剂）、肺药物（吸入β-激动剂、抗胆碱能药）、抗生素（四环素、克林霉素和大环内酯、利奈唑胺）、阿片类和非阿片类镇痛药（NSAID、COX-2 抑制剂、对乙酰氨基酚）、加巴喷烷类、勃起功能障碍 (ED) 药物和精神药物药物（三环类抗抑郁药 [TCAs]、单胺氧化酶抑制剂 [MAOI]、选择性血清素再摄取抑制剂 [SSRIs]、

材料和方法：从 2000 年 1 月到 2021 年 2 月，使用以下搜索词/关键字通过 PubMed 和 Google Scholar 在 Medline 数据库中进行了在线搜索：“围手术期的慢性药物”和“慢性药物和麻醉影响”。此外，我们还搜索了与主要药物组相关的麻醉剂副作用。

结果和结论：了解最常用的慢性药物的药理学和药代动力学对于避免围手术期的不良后果很重要。这些药物相互作用可能会导致手术期间施用的麻醉药物的功效和毒性发生改变。这些药物相互作用也会影响手术患者的发病率、死亡率和恢复时间。这篇由两部分组成的评论文章的第一部分重点介绍了手术患者在术前最常服用的慢性药物的作用机制和不良副作用。