During perioperative medication reconciliation, which meds are commonly held or adjusted?

• A. Anticoagulants/antiplatelets
• B. Sedatives/herbal supplements
• C. Insulin/antidiabetics
• D. All of the above

Answer: (D)

During perioperative medication reconciliation, focus is on drugs that can affect bleeding, anesthesia effects, or metabolic balance, so several classes are routinely paused or adjusted. Anticoagulants and antiplatelets are commonly held before surgery to minimize intraoperative and postoperative bleeding, with decisions about bridging made based on the patient’s thrombotic risk and the type of procedure. Sedatives and herbal supplements are often held or modified because they can interact with anesthesia, potentiate sedation or hemodynamic instability, and some herbal products can affect bleeding risk or cardiac conduction. Insulin and other antidiabetics require careful planning around fasting and anesthesia to maintain safe blood glucose levels; this often means adjusting or holding doses and arranging close intraoperative and postoperative glucose monitoring or even an IV insulin infusion if needed. Because these adjustments address different aspects of perioperative safety—bleeding risk, anesthetic interactions, and glucose control—they are all commonly considered in reconciliation, making the option that encompasses all of these the best choice.