Premedication and management of concomitant therapy

The management of a patient's co existing illnesses, including decisions about their normal medication is an important part of their perioperative care. Adequate pre-assessment, preparation and liaison with other healthcare professionals is essential to decrease patient morbidity and mortality and prevent unnecessary surgical delay or suboptimal management. A full medication history including prescribed, over-the-counter and complementary medications is required, along with decisions regarding which medications should be omitted, have dose alterations or formulation changes to account for nil by mouth status. Medications may need to be prescribed in addition to the patient's normal medications, for example thromboembolic prophylaxis. This article also summarizes current recommendations with regard to premedication and concomitant medication.