Endocrine and metabolic agents represent the fifth highest volume of prescription medications dispensed by U.S. community pharmacies. Familiarity with these drugs when taken by our patients is helpful in confirming associated medical diagnoses; conversely, knowing the medical diagnosis, a clinician can anticipate the drugs his/her patient is taking. Before treating a patient taking endocrine and metabolic agents estimate the patient’s perioperative risk for a MME predicated on procedure-specific and patient-specific variables.
In an asymptomatic patient, if the risk is determined to be low and the patient’s functional capacity is ≥4 METs, no further evaluation may be required before treatment. In a symptomatic patient, if the risk is determined to be elevated, but the patient’s functional capacity is ≥4 METs routine medical evaluation and risk modification is advised. In a symptomatic patient, if the risk is determined to be elevated and the patient’s functional capacity is <4 METs immediate medical evaluation and risk modification is recommended.
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