Table 7.

Examples of complications which resolved on re-institution of preadmission medicines.

Diagnosis/age	Drug withdrawn	Symptoms	Consequences	Resolution
Breast cancer with secondary deposits
63 years	Nitrazepam	Psychotic, confused, drowsy	? cerebral mets, CT scan, lumbar puncture, power of attornery withdrawn permanently, lawyers involved, family rifts	Diazepam started once nitrazepam withdrawal recognized as cause of symptoms, lucid within 12 h.
Abdominal aortic aneurysm repair
75 years	Sinemet	Movements difficult during this time	Mobilization delayed and chest complications	Symptoms resolved once Sinemet re-introduced day 9 postop.
Aorto-bi-iliac graft
85 years	Doxepin	Tearful, anxious and depressed	Mobilization delayed	Doxepin reintroduced 23 days later and patient much improved
Caecopexy
66 years	Sinemet	Movements difficult during this time	Mobilization delayed and chest complications	Symptoms resolved once Sinemet re-introduced.
Aorto-bi-iliac graft
63 years	Sotalol, lisinopril	Day 1 postop pulmonary oedema and systolic BP > 200 mmHg despite adequate pain control and other causes eliminated, day 6 started sips, and hypertensive again	Needed prn nifedipine sl to control hypertension	Admission meds re-instated day 6 and became normotensive.
Left hemicolectomy/anterior resection
67 years	Captopril, pindolol, bumetanide	Day 2 systolic BP > 200 mmHg despite adequate pain control and other causes eliminated. Also BP became quite labile. Day 7 bp 175/90 mmHg	Intravenous metoprolol given until day 5 and nifedipine sl until day 8	Captopril restarted day 8, became normotensive
Abdominoperineal resection
69 years	Viskaldix	Steady rise in BP. Day 4190/100 mmHg + headache	Still ‘nbm’ but Visaldix recommenced	Normotensive day 4 and fluids introduced day 6.
Transverse colectomy
64 years	Cyclopenthiazide, diltiazem
		Day 3 BP 200/130 mmHg	Pain from concurrent osteoarthritis Mobilization a problem because of NSAID withheld	Needed 3 dose of nipedipine to become normotensive Restarted on diltiazem and became normotensive
Abdominoperineal resection
67 years	Enalapril, nadolol	Hypertensive, 190/120 mmHg (Day 1) 200/116 mmHg (Day 2) 230/120 mmHg (Day 3)	Needed prn nifedipine sl to control hypertension	Admission meds re-instated day 3 and became normotensive.
Anterior resection
65 years	Enalapril	Day 3 hypertensive 190/110 mmHg	Re-started admission meds	Admission meds re-instated day 3 and became normotensive