Which of the following medicine must be stopped 48 hours before surgery?

RUHS, Jaipur, PB B.Sc Nursing Entrance-2022

Medical & Surgical Nursing

Easy

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2022

Explanation

Ibuprofen is classified as a Nonsteroidal Anti-Inflammatory Drug (NSAID).
NSAIDs cause a temporary and reversible inhibition of platelet aggregation, which is crucial for forming blood clots.
The effect of ibuprofen wears off as the drug is metabolized and cleared from the body.
Stopping the medication 48 hours (2 days) before a surgical procedure is a standard guideline to ensure that platelet function has returned to normal, thereby minimizing the risk of excessive intraoperative or postoperative bleeding.

Option A: Aspirin must be stopped much earlier than 48 hours before surgery.
Option C: Morphine is an opioid analgesic that does not affect blood clotting mechanisms.
Option D: Gentamycin is an antibiotic and does not have antiplatelet or anticoagulant properties.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Preoperative medication management and bleeding risk as background academic context rather than a clinical decision trigger.
A thorough preoperative medication reconciliation is a critical nursing responsibility to prevent life-threatening surgical complications like hemorrhage.
Patient education must be clear, specific, and confirmed for understanding. Patients often do not realize that common over-the-counter drugs like aspirin and ibuprofen can have serious surgical implications.
What if? If a patient requires emergency surgery and has taken ibuprofen within the last 48 hours, the surgical and anesthesia teams must be notified immediately. They may need to have blood products, such as platelets, available in the operating room.

How to Approach the Question

First, identify the key parameter in the question, which is the specific timeframe: '48 hours before surgery'.
Next, categorize each medication option by its drug class: Aspirin (antiplatelet), Ibuprofen (NSAID), Morphine (opioid analgesic), and Gentamycin (antibiotic).
Recall the mechanism of action for each class, focusing on its effect on hemostasis (blood clotting).
Differentiate between the duration of action for drugs affecting platelets. Aspirin's effect is irreversible (lasting 7-10 days), while NSAIDs like ibuprofen have a reversible, shorter-acting effect.
Match the 48-hour timeframe to the drug with the corresponding duration of action. Ibuprofen's reversible effect aligns with the 48-hour discontinuation window, making it the correct choice.

Concept Tested & Keywords

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